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General NPI Number Information
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NPI Number | 1215344296
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 255 HOPE ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-2261
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Country | US
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Telephone | 401-337-5684
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Fax | 401-337-9290
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Provider Business Mailing Address
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Address Line | 255 HOPE ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-2261
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Country | US
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Telephone | 401-337-5684
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Fax | 401-337-9290
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIN KOLESAR FABRIS
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Credential | D.C.
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Telephone | 401-337-5684
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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 | 3464
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License Number State | MA
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