Provider Demographics
NPI:1326379652
Name:BATES, ROBERT BRIGHAM (DC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BRIGHAM
Last Name:BATES
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 1:104 WHALON STREET
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420
Mailing Address - Country:US
Mailing Address - Phone:978-343-4798
Mailing Address - Fax:978-343-4815
Practice Address - Street 1:104 WHALON ST STE 2C
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420
Practice Address - Country:US
Practice Address - Phone:978-343-4798
Practice Address - Fax:978-343-4815
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor