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NPI Code Detail

MEDICARE: MR. RICHARD JOSEPH MCGOVERN JR. DC

MEDICARE:  MR. RICHARD JOSEPH MCGOVERN JR. DC
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
1111N00000XChiropractor2791MA

General Provider Information

NPI Number : 1720246820
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD JOSEPH MCGOVERN JR. DC
Provider Business Mailing Address
First Line : 184 SUMNER ST
Second Line :
City : EAST BOSTON
State : MA
Zip : 02128-2322
Country : US
Telephone Number : 617-567-3300
Fax Number : 617-567-8500
Provider Business Practice Location Address
First Line : 184 SUMNER ST
Second Line :
City : EAST BOSTON
State : MA
Zip : 02128-2322
Country : US
Telephone Number : 617-567-3300
Fax Number : 617-567-8500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 05/27/2008

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Directions to “ MR. RICHARD JOSEPH MCGOVERN JR. DC” Practice Location

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