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General NPI Number Information
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NPI Number | 1992861157
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Entity Type | Organization
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Legal Business Name | DELISLE CHIROPRACTIC
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 05/25/2019
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Provider Practice Location Address
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Address Line | 14 MANNING AVE STE 303
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City | LEOMINSTER
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State | MA
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Zip | 01453-5790
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Country | US
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Telephone | 978-537-2490
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Fax | 978-534-8060
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Provider Business Mailing Address
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Address Line | 14 MANNING AVE STE 303
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City | LEOMINSTER
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State | MA
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Zip | 01453-5790
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Country | US
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Telephone | 978-537-2490
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Fax | 978-534-8060
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | MATTHEW H DELISLE
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Credential | DC
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Telephone | 978-537-2490
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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 | 2438
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License Number State | MA
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