MEDICARE: ERIC DIENER INC.

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	2162	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y39596	OTHER		BCBS

General Provider Information

NPI Number	:	1760481345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC DIENER INC.

Provider Business Mailing Address
First Line	:	995 WASHINGTON ST
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02189-1928
Country	:	US
Telephone Number	:	781-337-7777
Fax Number	:	781-337-2803

Provider Business Practice Location Address
First Line	:	995 WASHINGTON ST
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02189-1928
Country	:	US
Telephone Number	:	781-337-7777
Fax Number	:	781-337-2803

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. ERIC ROBERT DIENER
Credential	:	D.C.
Telephone Number	:	781-337-7777

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	08/22/2020

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Directions to “ERIC DIENER INC. ” Practice Location

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