Provider Demographics
NPI:1760223440
Name:PACI, ISABEL ROSE
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:ROSE
Last Name:PACI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13992 BALTIMORE AVE STE 201A
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5010
Mailing Address - Country:US
Mailing Address - Phone:301-953-0256
Mailing Address - Fax:
Practice Address - Street 1:13992 BALTIMORE AVE
Practice Address - Street 2:#201A
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5010
Practice Address - Country:US
Practice Address - Phone:301-953-0256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor