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NPI 1174637839

NPI 1174637839 : GRACE RENA MAE CATER DC : QUINCY, MA

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General NPI Number Information
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    NPI Number           |    1174637839
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    Entity Type          |    Individual 
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    Provider Name        |    GRACE RENA MAE CATER DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/19/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1212 HANCOCK ST FIRST SPINE & REHAB
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    City                 |    QUINCY
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    State                |    MA
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    Zip                  |    02169
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    Country              |    US
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    Telephone            |    617-745-0555
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    Fax                  |    617-745-0554
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Provider Business Mailing Address
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    Address Line         |    6 POST OAK LANE #9 
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    City                 |    NATICK
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    State                |    MA
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    Zip                  |    01760
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    Country              |    US
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    Telephone            |    617-823-5020
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    Fax                  |    508-651-0204
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    1765
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    License Number State |    MA
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