Healthcare Provider Details

I. General information

NPI: 1134792427
Provider Name (Legal Business Name): PRECISION CHIROPRACTIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2021
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 WESTMINSTER ST
PROVIDENCE RI
02909-1413
US

IV. Provider business mailing address

1268 WESTMINSTER ST
PROVIDENCE RI
02909-1413
US

V. Phone/Fax

Practice location:
  • Phone: 401-459-6780
  • Fax: 401-459-6783
Mailing address:
  • Phone: 401-459-6780
  • Fax: 401-459-6783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGG ALLEN MEDEIROS
Title or Position: PRESIDENT
Credential: DC
Phone: 401-459-6780