Provider Demographics
NPI:1568612547
Name:CHIROPRACTIC CARE CENTERS, INC
Entity Type:Organization
Organization Name:CHIROPRACTIC CARE CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-559-8725
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:NEWTON UPPER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02464-0001
Mailing Address - Country:US
Mailing Address - Phone:781-559-8725
Mailing Address - Fax:781-559-8774
Practice Address - Street 1:503 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-5371
Practice Address - Country:US
Practice Address - Phone:978-353-7716
Practice Address - Fax:978-353-7718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110081876BMedicaid
MAY40176OtherBCBS
MAY40176OtherBCBS