Provider Demographics
NPI:1114937869
Name:FARRELL, BRIAN T (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:T
Last Name:FARRELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BOSTON RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3526
Mailing Address - Country:US
Mailing Address - Phone:978-250-1500
Mailing Address - Fax:978-250-1515
Practice Address - Street 1:6 BOSTON RD
Practice Address - Street 2:SUITE 107
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3526
Practice Address - Country:US
Practice Address - Phone:978-250-1500
Practice Address - Fax:978-250-1515
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0022278OtherNHP
MAAA54242OtherHARVARD PILGRIM
MA1612778Medicaid
MAY36018OtherBCBS
MAY36018Medicare ID - Type Unspecified