Provider Demographics
NPI:1639371057
Name:UNION CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:UNION CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:STONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:978-443-4344
Mailing Address - Street 1:323 BOSTON POST RD
Mailing Address - Street 2:#2A
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3022
Mailing Address - Country:US
Mailing Address - Phone:978-443-4344
Mailing Address - Fax:978-443-8383
Practice Address - Street 1:323 BOSTON POST RD
Practice Address - Street 2:#2A
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3022
Practice Address - Country:US
Practice Address - Phone:978-443-4344
Practice Address - Fax:978-443-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9706071Medicaid
MA9706071Medicaid