Provider Demographics
NPI:1902121064
Name:MOZAFARI, BOBBAK (DC)
Entity Type:Individual
Prefix:DR
First Name:BOBBAK
Middle Name:
Last Name:MOZAFARI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BOBBY
Other - Middle Name:
Other - Last Name:MOZAFARI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:6860 OLNEY LAYTONSVILLE RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:LAYTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1921
Mailing Address - Country:US
Mailing Address - Phone:301-570-7970
Mailing Address - Fax:301-570-7971
Practice Address - Street 1:6860 OLNEY LAYTONSVILLE RD UNIT 3
Practice Address - Street 2:
Practice Address - City:LAYTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20882-1921
Practice Address - Country:US
Practice Address - Phone:301-570-7970
Practice Address - Fax:301-570-7971
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03751111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation