Provider Demographics
NPI:1467467563
Name:DEFRANCA, GEORGE GREGORY (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:GREGORY
Last Name:DEFRANCA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-0381
Mailing Address - Country:US
Mailing Address - Phone:508-835-2271
Mailing Address - Fax:508-835-3476
Practice Address - Street 1:73 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1418
Practice Address - Country:US
Practice Address - Phone:508-835-2271
Practice Address - Fax:508-835-3476
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35045OtherHARVARD PILGRIM
MAY35496OtherBLUE CROSS
MAT58209Medicare UPIN
MAY35496Medicare ID - Type Unspecified