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General NPI Number Information
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NPI Number | 1750588737
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Entity Type | Organization
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Legal Business Name | GOLD STAR CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3 RUTHVEN AVE
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City | WORCESTER
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State | MA
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Zip | 01606-2827
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Country | US
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Telephone | 508-854-4868
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Fax | 508-853-9271
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Provider Business Mailing Address
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Address Line | 3 RUTHVEN AVE
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City | WORCESTER
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State | MA
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Zip | 01606-2827
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Country | US
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Telephone | 508-854-4868
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Fax | 508-853-9271
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Authorized Official
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Title or Position | OWNER
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Name | DR. FRANCIS P ERMILIO
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Credential | DC
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Telephone | 508-854-4868
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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 | 1133
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License Number State | MA
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