Provider Demographics
NPI:1063815066
Name:GIOLEKAS SPORTS AND FAMILY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:GIOLEKAS SPORTS AND FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOLEKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-752-7334
Mailing Address - Street 1:488 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1857
Mailing Address - Country:US
Mailing Address - Phone:508-752-7334
Mailing Address - Fax:508-752-8469
Practice Address - Street 1:488 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1857
Practice Address - Country:US
Practice Address - Phone:508-752-7334
Practice Address - Fax:508-752-8469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2228111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty