Provider Demographics
NPI:1326287129
Name:DECKER CHIROPRACTIC
Entity Type:Organization
Organization Name:DECKER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-591-9200
Mailing Address - Street 1:259 ELM ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2950
Mailing Address - Country:US
Mailing Address - Phone:617-591-9200
Mailing Address - Fax:617-591-8100
Practice Address - Street 1:259 ELM ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2950
Practice Address - Country:US
Practice Address - Phone:617-591-9200
Practice Address - Fax:617-591-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3220111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty