Healthcare Provider Details

I. General information

NPI: 1902099609
Provider Name (Legal Business Name): OXFORD FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2007
Last Update Date: 08/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SIGOURNEY ST
OXFORD MA
01540-1943
US

IV. Provider business mailing address

7 SIGOURNEY ST
OXFORD MA
01540-1943
US

V. Phone/Fax

Practice location:
  • Phone: 508-987-3200
  • Fax:
Mailing address:
  • Phone: 508-987-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1029
License Number StateMA

VIII. Authorized Official

Name: DR. ANDRE MAILHOT
Title or Position: OWNER
Credential: D.C.
Phone: 508-987-3200