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General NPI Number Information
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NPI Number | 1932980315
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC BUSINESS ASSOCIATES INC.
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 1103 MAIN ST
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City | LEICESTER
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State | MA
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Zip | 01524-1393
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Country | US
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Telephone | 508-892-8150
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Fax |
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Provider Business Mailing Address
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Address Line | 1103 MAIN ST
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City | LEICESTER
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State | MA
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Zip | 01524-1393
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Country | US
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Telephone | 508-892-8150
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PETER J ANTANAVICA
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Credential | DC
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Telephone | 508-892-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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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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