Provider Demographics
NPI:1093856809
Name:HEALING HANDS CHIROPRACTIC
Entity Type:Organization
Organization Name:HEALING HANDS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:H
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-752-5150
Mailing Address - Street 1:21 N QUINSIGAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-2400
Mailing Address - Country:US
Mailing Address - Phone:508-752-5150
Mailing Address - Fax:508-752-2240
Practice Address - Street 1:21 N QUINSIGAMOND AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-2400
Practice Address - Country:US
Practice Address - Phone:508-752-5150
Practice Address - Fax:508-752-2240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2627111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1601148Medicaid
MA1601148Medicaid