=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275620643
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN D BOYDEN D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 AMHERST RD
-----------------------------------------------------
City | SUNDERLAND
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01375-9466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-665-3336
-----------------------------------------------------
Fax | 413-665-3337
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 AMHERST RD
-----------------------------------------------------
City | SUNDERLAND
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01375-9466
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-665-3336
-----------------------------------------------------
Fax | 413-665-3337
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 231
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------