Provider Demographics
NPI:1528608379
Name:BALTIMORE INTEGRATIVE HEALTH LLC
Entity type:Organization
Organization Name:BALTIMORE INTEGRATIVE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-251-0037
Mailing Address - Street 1:30 WEST GUDE DR
Mailing Address - Street 2:SUITE 375
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5987
Mailing Address - Country:US
Mailing Address - Phone:301-251-0037
Mailing Address - Fax:301-545-0885
Practice Address - Street 1:1800 N CHARLES ST STE 810
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5987
Practice Address - Country:US
Practice Address - Phone:410-982-6440
Practice Address - Fax:410-982-6387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty