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General NPI Number Information
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NPI Number | 1295195584
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Entity Type | Organization
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Legal Business Name | MCGOVERN FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 02/29/2016
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Last Update Date | 02/29/2016
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Provider Practice Location Address
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Address Line | 47 ELM ST STE 3
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City | DANVERS
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State | MA
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Zip | 01923-2835
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Country | US
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Telephone | 978-646-0010
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Fax | 978-646-0076
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Provider Business Mailing Address
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Address Line | 47 ELM ST STE 3
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City | DANVERS
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State | MA
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Zip | 01923-2835
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Country | US
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Telephone | 978-646-0010
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Fax | 978-646-0076
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW MICHAEL MCGOVERN
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Credential | D.C
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Telephone | 315-272-9746
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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 | 3511
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License Number State | MA
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