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General NPI Number Information
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NPI Number | 1215461728
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Entity Type | Organization
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Legal Business Name | CHIRO-DYNAMICS SPINE & JOINTS REHAB LLC
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 42 EASTERN AVE
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City | MALDEN
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State | MA
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Zip | 02148-5014
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Country | US
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Telephone | 781-605-3438
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Fax | 781-605-3648
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Provider Business Mailing Address
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Address Line | 1744 ROSWELL RD STE 200
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City | MARIETTA
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State | GA
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Zip | 30062-3979
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Country | US
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Telephone | 404-552-2807
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Fax | 781-605-3438
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDRA JEAN BAPTISTE
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Credential | P.A, MD
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Telephone | 781-605-3438
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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 |
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License Number State |
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