Healthcare Provider Details

I. General information

NPI: 1922077502
Provider Name (Legal Business Name): SPINAL THERAPY & REHABILITATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 TURNPIKE RD
IPSWICH MA
01938-1003
US

IV. Provider business mailing address

77 TURNPIKE RD
IPSWICH MA
01938-1003
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-5525
  • Fax: 978-356-5584
Mailing address:
  • Phone: 978-356-5525
  • Fax: 978-356-5584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1616
License Number StateMA

VIII. Authorized Official

Name: DR. JOSEPH FRANK DEMARCO
Title or Position: PRESIDENT
Credential: DC
Phone: 978-356-5525