Provider Demographics
NPI:1598974511
Name:GREGORY A. BAUER, D.C.,P.C.
Entity Type:Organization
Organization Name:GREGORY A. BAUER, D.C.,P.C.
Other - Org Name:ARLINGTON CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-648-4000
Mailing Address - Street 1:42 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6515
Mailing Address - Country:US
Mailing Address - Phone:781-648-4000
Mailing Address - Fax:
Practice Address - Street 1:42 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-6515
Practice Address - Country:US
Practice Address - Phone:781-648-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1600346Medicaid
MA1600346Medicaid