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General NPI Number Information
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NPI Number | 1902011646
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Entity Type | Organization
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Legal Business Name | PALLIS CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 521 WALPOLE ST
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City | NORWOOD
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State | MA
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Zip | 02062-1736
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Country | US
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Telephone | 781-255-7080
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Fax |
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Provider Business Mailing Address
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Address Line | 521 WALPOLE ST
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City | NORWOOD
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State | MA
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Zip | 02062-1736
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Country | US
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Telephone | 781-255-7080
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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. MATTHEW MICHAUD
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Credential | D.C.
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Telephone | 781-255-7080
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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 | 2905
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License Number State | MA
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