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General NPI Number Information
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NPI Number | 1083089908
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Entity Type | Organization
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Legal Business Name | HEALTHSOURCE OF SHREWSBURY, INC
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 512 MAIN ST SUITE 6
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City | SHREWSBURY
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State | MA
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Zip | 01545-6405
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Country | US
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Telephone | 508-842-4774
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Fax | 508-842-5633
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Provider Business Mailing Address
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Address Line | 512 MAIN ST SUITE 6
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City | SHREWSBURY
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State | MA
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Zip | 01545-6405
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Country | US
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Telephone | 508-842-4774
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Fax | 508-842-5633
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. RYAN P MESSINA
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Credential | D.C.
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Telephone | 508-842-4774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3645
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License Number State | MA
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