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General NPI Number Information
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NPI Number | 1508027483
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Entity Type | Organization
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Legal Business Name | CICCONE CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 131 MAIN STREET SUITE 7
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City | SOUTH LANCASTER
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State | MA
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Zip | 01561
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Country | US
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Telephone | 978-368-3330
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Fax | 978-368-3337
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Provider Business Mailing Address
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Address Line | PO BOX 486
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City | SOUTH LANCASTER
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State | MA
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Zip | 01561-0486
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Country | US
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Telephone | 978-368-3330
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Fax | 978-368-3337
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. DENNIS JAMES CICCONE JR.
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Credential | D.C.
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Telephone | 978-368-3330
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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 | 3045
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License Number State | MA
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