Healthcare Provider Details

I. General information

NPI: 1871591081
Provider Name (Legal Business Name): PETER J SCHWARTZ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

266 MAIN ST
SPENCER MA
01562-1846
US

IV. Provider business mailing address

PO BOX 326
SPENCER MA
01562-0326
US

V. Phone/Fax

Practice location:
  • Phone: 508-885-5828
  • Fax: 508-885-5828
Mailing address:
  • Phone: 508-885-5828
  • Fax: 508-885-5828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number364
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: