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General NPI Number Information
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NPI Number | 1548276629
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Entity Type | Individual
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Provider Name | MARY CONNORS
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 1935 WASHINGTON ST
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City | STOUGHTON
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State | MA
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Zip | 02072-3350
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Country | US
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Telephone | 781-436-5006
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Fax | 781-436-8197
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Provider Business Mailing Address
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Address Line | 1935 WASHINGTON ST
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City | STOUGHTON
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State | MA
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Zip | 02072-3350
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Country | US
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Telephone | 781-436-5006
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Fax | 781-436-8197
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CH 945
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License Number State | MA
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