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General NPI Number Information
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NPI Number | 1245337427
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Entity Type | Organization
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Legal Business Name | ATLANTIC CHIROPRACTIC & REHAB., INC.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 303 JEFFERSON BLVD
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City | WARWICK
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State | RI
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Zip | 02888-3845
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Country | US
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Telephone | 401-490-2022
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Fax | 401-490-2392
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Provider Business Mailing Address
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Address Line | PO BOX 8458
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City | WARWICK
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State | RI
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Zip | 02888-0597
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Country | US
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Telephone | 401-490-2022
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Fax | 401-490-2392
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRENCE G AUSSANT
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Credential | D.C.
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Telephone | 508-369-6613
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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 | DCP00521
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License Number State | RI
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