Provider Demographics
NPI:1275122392
Name:PERRY FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:PERRY FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEAGUDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-750-9755
Mailing Address - Street 1:696 PLAIN ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2100
Mailing Address - Country:US
Mailing Address - Phone:617-750-9755
Mailing Address - Fax:
Practice Address - Street 1:696 PLAIN ST STE 1A
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2100
Practice Address - Country:US
Practice Address - Phone:617-750-9755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty