Provider Demographics
NPI:1285820589
Name:KEVIN M. O'BRIEN DC PC
Entity Type:Organization
Organization Name:KEVIN M. O'BRIEN DC PC
Other - Org Name:DBA O'BRIEN CHIROPRACTIC OFFICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FACO, DACNB
Authorized Official - Phone:978-975-8510
Mailing Address - Street 1:120 PLEASANT VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-7204
Mailing Address - Country:US
Mailing Address - Phone:978-975-8510
Mailing Address - Fax:978-975-5190
Practice Address - Street 1:120 PLEASANT VALLEY ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7204
Practice Address - Country:US
Practice Address - Phone:978-975-8510
Practice Address - Fax:978-975-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADC1626111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
351232OtherHARVARD PILGRIM
Y4004OtherBC/BS GROUP
Y36129OtherBLUE CROSS/BLUE SHIELD
Y4004OtherBC/BS GROUP