Provider Demographics
NPI:1003000209
Name:KOPELMAN FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:KOPELMAN FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KOPELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-388-6462
Mailing Address - Street 1:411 MASS AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3739
Mailing Address - Country:US
Mailing Address - Phone:978-263-0008
Mailing Address - Fax:978-264-4462
Practice Address - Street 1:411 MASS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3739
Practice Address - Country:US
Practice Address - Phone:978-263-0008
Practice Address - Fax:978-264-4462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY39959OtherBCBS