Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | S03880 | MD |
NPI | 1164870283 |
---|---|
Provider Name | Sarah Corcoran |
First Address | Fort Washington, MD 20744 |
Second Address | Columbia, MD 21044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2016 |
Last Update Date | 31/05/2016 |