Healthcare Provider Details

I. General information

NPI: 1467898254
Provider Name (Legal Business Name): MIJORZ CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 NORTH ST
PITTSFIELD MA
01201
US

IV. Provider business mailing address

835 NORTH ST.
PITTSFIELD MA
01201
US

V. Phone/Fax

Practice location:
  • Phone: 413-442-5022
  • Fax: 413-499-1946
Mailing address:
  • Phone: 413-442-5022
  • Fax: 413-499-1946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1223
License Number StateMA

VIII. Authorized Official

Name: MARY JANE PIAZZA
Title or Position: PRESIDENT
Credential:
Phone: 413-698-2215