Provider Demographics
NPI:1346569282
Name:ADVANCED CHIROPRACTIC THERAPY LLC
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:REUVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZASLAVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-296-3951
Mailing Address - Street 1:PO BOX 67373
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-0004
Mailing Address - Country:US
Mailing Address - Phone:617-296-3951
Mailing Address - Fax:617-296-1036
Practice Address - Street 1:1651 BLUE HILL AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2109
Practice Address - Country:US
Practice Address - Phone:617-296-3951
Practice Address - Fax:617-296-1036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center