Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | S04020 | MD |
NPI | 1366095051 |
---|---|
Provider Name | Eunice Hannah Stewart |
First Address | Baltimore, MD 21212-2978 |
Second Address | Bel Air, MD 21014-4244 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2019 |
Last Update Date | 22/07/2019 |