Healthcare Provider Details

I. General information

NPI: 1912931841
Provider Name (Legal Business Name): TERRANCE GARTH AUSSANT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 N MAIN ST
ATTLEBORO MA
02703-2225
US

IV. Provider business mailing address

175 N MAIN ST
ATTLEBORO MA
02703-2225
US

V. Phone/Fax

Practice location:
  • Phone: 508-431-2520
  • Fax: 508-431-2925
Mailing address:
  • Phone: 508-431-2920
  • Fax: 508-431-2925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDCP 00521
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2877
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: