Provider Demographics
NPI:1578690897
Name:LAYDEN, BRETT MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:MICHAEL
Last Name:LAYDEN
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 1:1 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2112
Mailing Address - Country:US
Mailing Address - Phone:508-828-1918
Mailing Address - Fax:
Practice Address - Street 1:111 WASHINGTON ST
Practice Address - Street 2:SUITE 202A
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2155
Practice Address - Country:US
Practice Address - Phone:508-699-2553
Practice Address - Fax:508-695-5580
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1696840Medicaid
MA1696840Medicaid
MALAY45384Medicare ID - Type UnspecifiedMEDICARE