Healthcare Provider Details

I. General information

NPI: 1356419535
Provider Name (Legal Business Name): ANN M DOGGETT D.C., L.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 BRAINTREE HILL OFFICE PARK STE 101
BRAINTREE MA
02184-8702
US

IV. Provider business mailing address

15 BRAINTREE HILL OFFICE PARK STE 101
BRAINTREE MA
02184-8702
US

V. Phone/Fax

Practice location:
  • Phone: 617-328-6300
  • Fax: 617-328-7780
Mailing address:
  • Phone: 617-328-6300
  • Fax: 617-328-7780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1598
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1430
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number1598
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number1598
License Number StateMA
# 5
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1430
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: