Healthcare Provider Details

I. General information

NPI: 1629905997
Provider Name (Legal Business Name): ACCIDENT AND INJURY GROUP BROCKTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PEARL ST STE 1B
BROCKTON MA
02301-2866
US

IV. Provider business mailing address

404 TECHNOLOGY CENTER DR UNIT 3401
STOUGHTON MA
02072-4734
US

V. Phone/Fax

Practice location:
  • Phone: 305-588-6840
  • Fax:
Mailing address:
  • Phone: 305-588-6840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID GLADSTONE
Title or Position: DIRECTOR OF CLINICS
Credential: DC
Phone: 305-588-6840