Provider Demographics
NPI:1093841355
Name:NORTH END CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:NORTH END CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LOUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-742-5797
Mailing Address - Street 1:414 COMMERCIAL ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109
Mailing Address - Country:US
Mailing Address - Phone:617-742-5797
Mailing Address - Fax:617-742-8250
Practice Address - Street 1:414 COMMERCIAL ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109
Practice Address - Country:US
Practice Address - Phone:617-742-5797
Practice Address - Fax:617-742-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA716209OtherTUFTS
MAY35614OtherBLUE CROSS BLUE SHIELD
YY3007Medicare ID - Type Unspecified