Provider Demographics
NPI:1366645830
Name:METHUEN FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:METHUEN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:RONDINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-683-4410
Mailing Address - Street 1:112 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5045
Mailing Address - Country:US
Mailing Address - Phone:978-683-4410
Mailing Address - Fax:
Practice Address - Street 1:112 JACKSON ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5045
Practice Address - Country:US
Practice Address - Phone:978-683-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45427Medicare ID - Type Unspecified
MAU74403Medicare UPIN