MEDICARE: ABC FAMILY CHIROPRACTIC AND WELLNESS 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	921	MA

General Provider Information

NPI Number	:	1952582678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC FAMILY CHIROPRACTIC AND WELLNESS INC.

Provider Business Mailing Address
First Line	:	366 MASSACHUSETTS AVE
Second Line	:	SUITE 103
City	:	ARLINGTON
State	:	MA
Zip	:	02474-6733
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	366 MASSACHUSETTS AVE
Second Line	:	SUITE 103
City	:	ARLINGTON
State	:	MA
Zip	:	02474-6733
Country	:	US
Telephone Number	:	781-648-8500
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. MARK POTTER
Credential	:	DC
Telephone Number	:	781-648-8500

Provider Enumeration Date	:	11/21/2007
Last Update Date	:	01/04/2008

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