MEDICARE: SHEEHAN CHIROPRACTIC PC

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	111N00000X	Chiropractor	1182	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	716292	OTHER	MA	TUFTS HEALTH PLAN

General Provider Information

NPI Number	:	1710030937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEEHAN CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	60 CONCORD ST
Second Line	:	SUITE M
City	:	WILMINGTON
State	:	MA
Zip	:	01887-2179
Country	:	US
Telephone Number	:	978-658-8020
Fax Number	:	978-658-8857

Provider Business Practice Location Address
First Line	:	60 CONCORD ST
Second Line	:	SUITE M
City	:	WILMINGTON
State	:	MA
Zip	:	01887-2179
Country	:	US
Telephone Number	:	978-658-8020
Fax Number	:	978-658-8857

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS MICHAEL SHEEHAN
Credential	:	D.C.
Telephone Number	:	978-658-8020

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	08/22/2008

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