Provider Demographics
NPI:1043516982
Name:TAUNTON WELLNESS CENTER; INC.
Entity Type:Organization
Organization Name:TAUNTON WELLNESS CENTER; INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:CANCELLIERI-DETURCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-824-1200
Mailing Address - Street 1:244 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-1530
Mailing Address - Country:US
Mailing Address - Phone:508-824-1200
Mailing Address - Fax:508-824-2886
Practice Address - Street 1:244 BROADWAY
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-1530
Practice Address - Country:US
Practice Address - Phone:508-824-1200
Practice Address - Fax:508-824-2886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH1743111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty