Healthcare Provider Details

I. General information

NPI: 1144312893
Provider Name (Legal Business Name): BRIAN COEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 LINCOLN ST
WORCESTER MA
01605-2501
US

IV. Provider business mailing address

5B HIGHLAND ST
BOYLSTON MA
01505-1900
US

V. Phone/Fax

Practice location:
  • Phone: 508-795-1555
  • Fax: 508-755-4464
Mailing address:
  • Phone: 508-795-1555
  • Fax: 508-755-4464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2933
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: