Provider Demographics
NPI:1255872396
Name:CHIROWORX SPINE & REHAB, LLC
Entity type:Organization
Organization Name:CHIROWORX SPINE & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RILEY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-752-2330
Mailing Address - Street 1:1425 LIGHT ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4514
Mailing Address - Country:US
Mailing Address - Phone:410-752-2330
Mailing Address - Fax:
Practice Address - Street 1:1425 LIGHT ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-4514
Practice Address - Country:US
Practice Address - Phone:410-752-2330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty