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General NPI Number Information
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NPI Number | 1992824536
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Entity Type | Individual
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Provider Name | CHARLES E BAXTER D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 123 S MAIN ST
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City | ATHOL
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State | MA
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Zip | 01331-2131
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Country | US
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Telephone | 978-249-2225
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Fax | 978-249-7982
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Provider Business Mailing Address
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Address Line | 109 LUMBER ST
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City | ATHOL
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State | MA
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Zip | 01331-2219
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Country | US
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Telephone | 978-249-2225
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Fax | 978-249-7982
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1996
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License Number State | MA
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