Healthcare Provider Details

I. General information

NPI: 1316097025
Provider Name (Legal Business Name): ROBERT JOSEPH PERRAS JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 MIDDLESEX RD #3
TYNGSBORO MA
01879-1067
US

IV. Provider business mailing address

404 MIDDLESEX RD #3
TYNGSBORO MA
01879-1067
US

V. Phone/Fax

Practice location:
  • Phone: 978-649-5777
  • Fax: 978-649-5777
Mailing address:
  • Phone: 978-649-5777
  • Fax: 978-649-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1985
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: