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1073704607 NPI number — BASS CHIROPRACTIC & PHYSICAL THERAPY

NPI Number: 1073704607
Health Care Provider/Practitioner: BASS CHIROPRACTIC & PHYSICAL THERAPY

Information about “1073704607” NPI (BASS CHIROPRACTIC & PHYSICAL THERAPY) exists in 1073704607 in HTML format HTML  |  1073704607 in plain Text format TXT  |  1073704607 in PDF (Portable Document Format) PDF  |  1073704607 in an XML format XML  formats.

NPI Number : 1073704607 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073704607",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BASS CHIROPRACTIC & PHYSICAL THERAPY",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1145 MAIN ST",
    "SecondLineMailingAddress": "SUITE 107",
    "MailingAddressCityName": "SPRINGFIELD",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01103-2143",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "413-726-0912",
    "MailingAddressFaxNumber": "413-686-9305",
    "FirstLinePracticeLocationAddress": "1145 MAIN ST",
    "SecondLinePracticeLocationAddress": "SUITE 107",
    "PracticeLocationAddressCityName": "SPRINGFIELD",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01103-2143",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "413-726-0912",
    "PracticeLocationAddressFaxNumber": "413-686-9305",
    "EnumerationDate": "08/08/2007",
    "LastUpdateDate": "08/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MAWLA",
    "AuthorizedOfficialFirstName": "BASSAM",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "D.C",
    "AuthorizedOfficialTelephoneNumber": "413-726-0912",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "111NR0400X",
        "TaxonomyName": "Rehabilitation Chiropractor",
        "LicenseNumber": "3120",
        "LicenseNumberStateCode": "MA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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