Healthcare Provider Details

I. General information

NPI: 1952471534
Provider Name (Legal Business Name): AMY NYREN JUELIS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WORCESTER ST
NORTH GRAFTON MA
01536-1289
US

IV. Provider business mailing address

210 WORCESTER ST STE 1L
NORTH GRAFTON MA
01536-1289
US

V. Phone/Fax

Practice location:
  • Phone: 508-839-4835
  • Fax: 508-839-4837
Mailing address:
  • Phone: 508-839-4835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2626
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: