Healthcare Provider Details

I. General information

NPI: 1215047634
Provider Name (Legal Business Name): ANTHONY GABOR MONCTON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 SOUTH STREET
WESTBORO MA
01581
US

IV. Provider business mailing address

20 SOUTH STREET
WESTBORO MA
01581
US

V. Phone/Fax

Practice location:
  • Phone: 508-366-6630
  • Fax: 508-366-6640
Mailing address:
  • Phone: 508-366-6630
  • Fax: 508-366-6640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1792
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC00336
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCR914
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: