Provider Demographics
NPI:1407293053
Name:ATLANTIC COAST CHIROPRACTIC INC
Entity Type:Organization
Organization Name:ATLANTIC COAST CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SLAWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:774-305-4270
Mailing Address - Street 1:183 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-3469
Mailing Address - Country:US
Mailing Address - Phone:774-305-4270
Mailing Address - Fax:774-992-0248
Practice Address - Street 1:183 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3469
Practice Address - Country:US
Practice Address - Phone:774-305-4270
Practice Address - Fax:774-992-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0033541Medicare PIN