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NPI Code Detail

MEDICARE: MR. KRISTIAN FREDERICK MCCOY DC

MEDICARE:  MR. KRISTIAN FREDERICK MCCOY  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
1111N00000XChiropractorCH1982MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2AA28215OTHERMAHARRARD PILGRIM
3Y36415OTHERMABC BS OF MA

General Provider Information

NPI Number : 1831231349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KRISTIAN FREDERICK MCCOY DC
Provider Business Mailing Address
First Line : 9 BOSTON STREET
Second Line :
City : LYNN
State : MA
Zip : 01904-2536
Country : US
Telephone Number : 781-592-8089
Fax Number : 781-592-8091
Provider Business Practice Location Address
First Line : 9 BOSTON STREET
Second Line :
City : LYNN
State : MA
Zip : 01904-2536
Country : US
Telephone Number : 781-592-8089
Fax Number : 781-592-8091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 07/08/2007

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Directions to “ MR. KRISTIAN FREDERICK MCCOY DC” Practice Location

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