Provider Demographics
NPI:1164585246
Name:CEDAR STREET CHIROPRACTIC PC
Entity Type:Organization
Organization Name:CEDAR STREET CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BELESI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-435-8182
Mailing Address - Street 1:77 W MAIN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1684
Mailing Address - Country:US
Mailing Address - Phone:508-435-8182
Mailing Address - Fax:508-435-8183
Practice Address - Street 1:77 W MAIN ST
Practice Address - Street 2:SUITE 211
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1684
Practice Address - Country:US
Practice Address - Phone:508-435-8182
Practice Address - Fax:508-435-8183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty