Provider Demographics
NPI:1134139348
Name:SOLEY, JEFFREY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:SOLEY
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:PO BOX 890
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MA
Mailing Address - Zip Code:01033-0890
Mailing Address - Country:US
Mailing Address - Phone:413-562-3615
Mailing Address - Fax:413-562-3611
Practice Address - Street 1:70 COURT ST STE 1
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3521
Practice Address - Country:US
Practice Address - Phone:413-562-3615
Practice Address - Fax:413-562-3611
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y45041Medicare ID - Type Unspecified
MAU60144Medicare UPIN