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General NPI Number Information
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NPI Number | 1710012299
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Entity Type | Organization
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Legal Business Name | DORCHESTER BACK & NECK CENTER
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1652 DORCHESTER AVE
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City | DORCHESTER
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State | MA
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Zip | 02122-1317
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Country | US
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Telephone | 617-436-0600
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Fax | 617-436-0605
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Provider Business Mailing Address
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Address Line | 1652 DORCHESTER AVANUE
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City | BOSTON
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State | MA
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Zip | 02122-1317
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Country | US
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Telephone | 617-436-0600
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Fax | 617-436-0605
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. GEORGE THOMAS KREGER
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Credential | D.C.
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Telephone | 617-436-0600
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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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