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General NPI Number Information
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NPI Number | 1952885154
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Entity Type | Organization
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Legal Business Name | HEPBURN CHIROPRACTIC
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 614 BLUE HILL AVE STE A
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City | DORCHESTER
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State | MA
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Zip | 02121-3258
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Country | US
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Telephone | 617-287-2541
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 990951
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City | BOSTON
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State | MA
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Zip | 02199-0951
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Country | US
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Telephone | 617-287-2541
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GAIL THERESE HEPBURN
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Credential | DC
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Telephone | 617-287-2541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number |
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License Number State |
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