Provider Demographics
NPI:1235168246
Name:TORMAN, KENNETH H (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:H
Last Name:TORMAN
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 1:200 CHAUNCY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-1200
Mailing Address - Country:US
Mailing Address - Phone:508-339-6030
Mailing Address - Fax:508-339-6031
Practice Address - Street 1:200 CHAUNCY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1200
Practice Address - Country:US
Practice Address - Phone:508-339-6030
Practice Address - Fax:508-339-6031
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA00310OtherTUFTS INSURANCE
MA35075OtherCIGNA INSURANCE
MA44-00612OtherUNITED HEALTHCARE
MA0125257OtherAETNA INSURANCE
MAY35081Medicare ID - Type Unspecified