Provider Demographics
NPI:1043559073
Name:EVERETT CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:EVERETT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALIPEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-217-8575
Mailing Address - Street 1:218 COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LAUDERDALE BY THE SEA
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4451
Mailing Address - Country:US
Mailing Address - Phone:954-217-8575
Mailing Address - Fax:954-495-9111
Practice Address - Street 1:157 MAIN ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-5733
Practice Address - Country:US
Practice Address - Phone:954-217-8575
Practice Address - Fax:954-495-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty