Provider Demographics
NPI:1629272638
Name:HOPKINTON CHIROPRACTIC
Entity Type:Organization
Organization Name:HOPKINTON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-435-2225
Mailing Address - Street 1:22 SOUTH STREET SUITE 204
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748
Mailing Address - Country:US
Mailing Address - Phone:508-435-2225
Mailing Address - Fax:508-435-0195
Practice Address - Street 1:22 SOUTH STREET SUITE 204
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748
Practice Address - Country:US
Practice Address - Phone:508-435-2225
Practice Address - Fax:508-435-0195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2351111N00000X
MA2355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45267Medicare ID - Type UnspecifiedPROVIDER NUMBER
MAY45365Medicare ID - Type UnspecifiedPROVIDER NUMBER