Provider Demographics
NPI:1063499408
Name:TABOR, MARGARET ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ANN
Last Name:TABOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:TABOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:37 BRIMMER ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-1001
Mailing Address - Country:US
Mailing Address - Phone:617-742-7401
Mailing Address - Fax:617-742-7488
Practice Address - Street 1:1611 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4302
Practice Address - Country:US
Practice Address - Phone:617-661-5291
Practice Address - Fax:617-742-7488
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1952111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU66526Medicare UPIN
MAY45157Medicare ID - Type Unspecified