Provider Demographics
NPI:1629747217
Name:FULL POTENTIAL HEALTH PC
Entity Type:Organization
Organization Name:FULL POTENTIAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANARELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-593-2388
Mailing Address - Street 1:9 NAHANT ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-3221
Mailing Address - Country:US
Mailing Address - Phone:781-595-6560
Mailing Address - Fax:
Practice Address - Street 1:186 BURRILL ST
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1835
Practice Address - Country:US
Practice Address - Phone:781-593-2388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty