Provider Demographics
NPI:1528835287
Name:CHIROSPORT REHAB
Entity type:Organization
Organization Name:CHIROSPORT REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-587-2245
Mailing Address - Street 1:1 THREE WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2428
Mailing Address - Country:US
Mailing Address - Phone:716-587-2245
Mailing Address - Fax:
Practice Address - Street 1:1166 CRAIN HWY SUITE 109
Practice Address - Street 2:
Practice Address - City:GAMBRILS
Practice Address - State:MD
Practice Address - Zip Code:21054
Practice Address - Country:US
Practice Address - Phone:716-587-2245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty