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General NPI Number Information
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NPI Number | 1154835551
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC HEALTH CENTER, LLC
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 800 PROVIDENCE RD
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City | WHITINSVILLE
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State | MA
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Zip | 01588-2125
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Country | US
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Telephone | 508-234-8284
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Fax | 508-234-7558
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Provider Business Mailing Address
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Address Line | 800 PROVIDENCE RD
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City | WHITINSVILLE
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State | MA
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Zip | 01588-2125
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Country | US
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Telephone | 508-234-8284
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Fax | 508-234-7558
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | MRS. DEBBRA PENTLAND
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Credential | BILLING MANAGER
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Telephone | 508-234-8284
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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 | 3015
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License Number State | MA
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