Provider Demographics
NPI:1588814412
Name:CONCORD SPINAL REHAB CENTER
Entity Type:Organization
Organization Name:CONCORD SPINAL REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-318-0488
Mailing Address - Street 1:747 MAIN ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3302
Mailing Address - Country:US
Mailing Address - Phone:978-318-0488
Mailing Address - Fax:978-318-0388
Practice Address - Street 1:747 MAIN ST
Practice Address - Street 2:SUITE 316
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3302
Practice Address - Country:US
Practice Address - Phone:978-318-0488
Practice Address - Fax:978-318-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11126208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty