MEDICARE: DR. ERIC ROBERT DIENER 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	CH2162	MA

General Provider Information

NPI Number	:	1831383926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC ROBERT DIENER D.C.

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	:

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	:

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

Provider Enumeration Date	:	08/31/2007
Last Update Date	:	08/31/2007

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