Healthcare Provider Details
I. General information
NPI: 1871864256
Provider Name (Legal Business Name): SPRINGFIELD FAMILY CHIROPRACTIC LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2012
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
281 STATE ST STE 1F
SPRINGFIELD MA
01103-1997
US
IV. Provider business mailing address
PO BOX 3091
SPRINGFIELD MA
01101-3091
US
V. Phone/Fax
- Phone: 413-335-2558
- Fax: 866-711-9657
- Phone: 413-335-2558
- Fax: 866-711-9657
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | 3354 |
| License Number State | MA |
VIII. Authorized Official
Name: DR.
PAUL
JEFFREY
DION
Title or Position: CEO/OWNER/CHIROPRACTIC PHYSICIAN
Credential: D.C.
Phone: 413-335-2558