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General NPI Number Information
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NPI Number | 1639949035
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Entity Type | Organization
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Legal Business Name | SERENE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/05/2024
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 102 SHORE DR STE 104
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City | WORCESTER
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State | MA
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Zip | 01605-3154
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Country | US
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Telephone | 508-925-0056
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Fax | 339-216-9831
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Provider Business Mailing Address
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Address Line | 102 SHORE DR STE 104
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City | WORCESTER
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State | MA
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Zip | 01605-3154
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Country | US
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Telephone | 518-810-2952
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SERENA V HEARD
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Credential | DC
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Telephone | 518-810-2952
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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