Provider Demographics
NPI:1477273381
Name:HYATT CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:HYATT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:HYATT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-683-0123
Mailing Address - Street 1:227 EAST ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5463
Mailing Address - Country:US
Mailing Address - Phone:978-683-0123
Mailing Address - Fax:978-683-3888
Practice Address - Street 1:227 EAST ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5463
Practice Address - Country:US
Practice Address - Phone:978-683-0123
Practice Address - Fax:978-683-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty