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General NPI Number Information
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NPI Number | 1881715787
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Entity Type | Individual
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Provider Name | CARLO LONGOBARDO D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 372 CHANDLER ST STE 102
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City | WORCESTER
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State | MA
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Zip | 01602-3314
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Country | US
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Telephone | 508-795-1810
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Fax | 508-795-1282
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Provider Business Mailing Address
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Address Line | 372 CHANDLER ST STE 102
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City | WORCESTER
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State | MA
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Zip | 01602-3314
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Country | US
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Telephone | 508-795-1810
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Fax | 508-795-1282
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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 | MA-2086
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License Number State | MA
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