Healthcare Provider Details
I. General information
NPI: 1538316807
Provider Name (Legal Business Name): FALL RIVER SPINE & DISC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
235 HANOVER ST. SUITE 303
FALL RIVER MA
02720-5299
US
IV. Provider business mailing address
235 HANOVER ST. SUITE 303
FALL RIVER MA
02720-5299
US
V. Phone/Fax
- Phone: 508-676-7300
- Fax: 508-676-7310
- Phone: 508-676-7300
- Fax: 508-676-7310
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2505 |
| License Number State | MA |
VIII. Authorized Official
Name: DR.
RAJIV
NEHRA
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: D.C.
Phone: 508-676-7300