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General NPI Number Information
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NPI Number | 1982879052
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Entity Type | Organization
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Legal Business Name | AYURVEDA INTERNATIONAL
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 21 WEST ST
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City | WORCESTER
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State | MA
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Zip | 01609-2306
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Country | US
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Telephone | 508-753-0006
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Fax | 508-770-0618
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Provider Business Mailing Address
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Address Line | 21 WEST ST
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City | WORCESTER
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State | MA
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Zip | 01609-2306
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Country | US
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Telephone | 508-753-0006
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Fax | 508-770-0618
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABBAS QUTAB
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Credential |
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Telephone | 508-753-0006
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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 | 1753
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License Number State | MA
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