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General NPI Number Information
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NPI Number | 1922127059
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Entity Type | Organization
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Legal Business Name | BLACKSTONE VALLEY NATURAL HEALTH CENTER, P.C.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 271 MAIN ST.
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City | DOUGLAS
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State | MA
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Zip | 01516
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Country | US
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Telephone | 508-476-7500
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Fax | 508-476-9875
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Provider Business Mailing Address
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Address Line | 271 MAIN ST.
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City | DOUGLAS
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State | MA
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Zip | 01516
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Country | US
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Telephone | 508-476-7500
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Fax | 508-476-9875
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. DEBORAH ANN KUENZEL
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Credential | D.C.
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Telephone | 508-476-7500
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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 | 2247
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License Number State | MA
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