Provider Demographics
NPI:1376604918
Name:PRD, INC.
Entity Type:Organization
Organization Name:PRD, INC.
Other - Org Name:MORIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANSOM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-734-6245
Mailing Address - Street 1:425 UNION ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-4115
Mailing Address - Country:US
Mailing Address - Phone:413-734-6245
Mailing Address - Fax:413-734-5368
Practice Address - Street 1:425 UNION ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4115
Practice Address - Country:US
Practice Address - Phone:413-734-6245
Practice Address - Fax:413-734-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1602730OtherMASS HEALTH
MA33362OtherBMC HEALTHNET
MA2249365OtherFIRST HEALTH
MA668163OtherACN
MA34725OtherHEALTH NEW ENGLAND
MAY37046OtherBLUE CROSS & BLUE SHIELD
MA3778859OtherCIGNA
MA=========OtherCONSOLIDATED
MA33362OtherBMC HEALTHNET