Provider Demographics
NPI:1003354978
Name:KHALSA CHIROPRACTIC BACK BAY, INC
Entity Type:Organization
Organization Name:KHALSA CHIROPRACTIC BACK BAY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:MORRISSEY
Authorized Official - Last Name:POSNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-620-8680
Mailing Address - Street 1:376 BOYLSTON ST
Mailing Address - Street 2:301
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3812
Mailing Address - Country:US
Mailing Address - Phone:857-250-2939
Mailing Address - Fax:857-250-2938
Practice Address - Street 1:376 BOYLSTON ST
Practice Address - Street 2:301
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:857-250-2939
Practice Address - Fax:857-250-2938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty