Provider Demographics
NPI:1487730818
Name:WORLEY, JULIET R (DC)
Entity type:Individual
Prefix:DR
First Name:JULIET
Middle Name:R
Last Name:WORLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JULIET
Other - Middle Name:W
Other - Last Name:MARVENKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:8305 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-3125
Mailing Address - Country:US
Mailing Address - Phone:410-922-4341
Mailing Address - Fax:410-922-4341
Practice Address - Street 1:8305 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-3125
Practice Address - Country:US
Practice Address - Phone:410-922-4341
Practice Address - Fax:410-922-4341
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1865PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR533OtherGHMSI
MDKG86OtherCAREFIRST
MD282MMedicare ID - Type Unspecified