Healthcare Provider Details

I. General information

NPI: 1033329099
Provider Name (Legal Business Name): DEBRA LEE BABCOCK DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 12/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 RASCALLY RABBIT RD
MARSTONS MILLS MA
02648-1888
US

IV. Provider business mailing address

PO BOX 133
MASHPEE MA
02649-0133
US

V. Phone/Fax

Practice location:
  • Phone: 508-419-7070
  • Fax: 508-419-7071
Mailing address:
  • Phone: 508-419-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2503
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: