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General NPI Number Information
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NPI Number | 1609126390
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Entity Type | Organization
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Legal Business Name | CHRISTIAN FANTINI, DC, LLC
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 20 CENTRAL ST SUITE 109
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City | SALEM
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State | MA
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Zip | 01970-3739
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Country | US
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Telephone | 978-745-5454
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Fax | 978-745-5455
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Provider Business Mailing Address
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Address Line | 20 CENTRAL ST SUITE 109
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City | SALEM
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State | MA
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Zip | 01970-3739
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Country | US
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Telephone | 978-745-5454
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Fax | 978-745-5455
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTIAN FANTINI
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Credential | D.C.
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Telephone | 978-745-5454
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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 | 585
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License Number State | MA
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