Provider Demographics
NPI:1366832131
Name:BERK CHIROPRACTIC AND SPORTS CARE PC
Entity Type:Organization
Organization Name:BERK CHIROPRACTIC AND SPORTS CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:ZACHARY
Authorized Official - Last Name:BERK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-584-9888
Mailing Address - Street 1:234 RUSSELL ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-3534
Mailing Address - Country:US
Mailing Address - Phone:413-584-9888
Mailing Address - Fax:
Practice Address - Street 1:234 RUSSELL ST STE 201
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-3534
Practice Address - Country:US
Practice Address - Phone:413-584-9888
Practice Address - Fax:413-584-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3478111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty