Provider Demographics
NPI:1003096223
Name:CAETANO FAMILY CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:CAETANO FAMILY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE-MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAETANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-475-5956
Mailing Address - Street 1:515 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6934
Mailing Address - Country:US
Mailing Address - Phone:401-475-5956
Mailing Address - Fax:508-586-5188
Practice Address - Street 1:515 BROAD ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-6934
Practice Address - Country:US
Practice Address - Phone:401-475-5956
Practice Address - Fax:508-586-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI709003750Medicare PIN