MEDICARE: DR. JOHN RICHARD DAOUST DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	1352	MA

General Provider Information

NPI Number	:	1265581557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN RICHARD DAOUST DC

Provider Business Mailing Address
First Line	:	328 EAST ST
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-2009
Country	:	US
Telephone Number	:	781-740-1130
Fax Number	:

Provider Business Practice Location Address
First Line	:	328 EAST ST
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-2009
Country	:	US
Telephone Number	:	781-740-1130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	06/03/2011

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