Healthcare Provider Details

I. General information

NPI: 1487771044
Provider Name (Legal Business Name): NEW ENGLAND CHIROPRACTIC HEALTH CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 LINCOLN ST
WORCESTER MA
01605-2501
US

IV. Provider business mailing address

192 LINCOLN ST
WORCESTER MA
01605-2501
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 Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1492
License Number StateMA

VIII. Authorized Official

Name: DR. FREDRICK H. CHASSMAN
Title or Position: OWNER
Credential: D.C.
Phone: 508-795-1555