Provider Demographics
NPI:1023197043
Name:DRACUT CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:DRACUT CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GELINEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-453-2792
Mailing Address - Street 1:1533 LAKEVIEW AVE
Mailing Address - Street 2:SUITE2
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3324
Mailing Address - Country:US
Mailing Address - Phone:978-453-2792
Mailing Address - Fax:
Practice Address - Street 1:1533 LAKEVIEW AVE
Practice Address - Street 2:SUITE2
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-3324
Practice Address - Country:US
Practice Address - Phone:978-453-2792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MADRY49203Medicare ID - Type Unspecified