Provider Demographics
NPI:1447520457
Name:DIPESO CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:DIPESO CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DIPESO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-803-8480
Mailing Address - Street 1:2404 PLEASANTVILLE RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2099
Mailing Address - Country:US
Mailing Address - Phone:410-803-8480
Mailing Address - Fax:410-803-4840
Practice Address - Street 1:2404 PLEASANTVILLE RD
Practice Address - Street 2:SUITE 6
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2099
Practice Address - Country:US
Practice Address - Phone:410-803-8480
Practice Address - Fax:410-803-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01797111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty