Provider Demographics
NPI:1588649420
Name:NAUSET CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:NAUSET CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-240-1037
Mailing Address - Street 1:177 RT 6A
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02653-3206
Mailing Address - Country:US
Mailing Address - Phone:508-240-1037
Mailing Address - Fax:508-240-6843
Practice Address - Street 1:177 RT 6A
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653-3206
Practice Address - Country:US
Practice Address - Phone:508-240-1037
Practice Address - Fax:508-240-6843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36364OtherBC/BS
MAY36364Medicare ID - Type Unspecified