MEDICARE: DR. ERIC COUSINO D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3512	MA

General Provider Information

NPI Number	:	1669709937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC COUSINO D.C.

Provider Business Mailing Address
First Line	:	169 RT-6A
Second Line	:
City	:	ORLEANS
State	:	MA
Zip	:	02653
Country	:	US
Telephone Number	:	508-255-5866
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 RT 6A
Second Line	:
City	:	ORLEANS
State	:	MA
Zip	:	02653-3206
Country	:	US
Telephone Number	:	508-255-5866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2009
Last Update Date	:	03/03/2016

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