Provider Demographics
NPI:1639629520
Name:DEGRE CHIROPRACTIC OF METHUEN LLC
Entity Type:Organization
Organization Name:DEGRE CHIROPRACTIC OF METHUEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAURENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-459-0778
Mailing Address - Street 1:271 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6826
Mailing Address - Country:US
Mailing Address - Phone:978-208-0527
Mailing Address - Fax:978-208-1522
Practice Address - Street 1:271 BROADWAY
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6826
Practice Address - Country:US
Practice Address - Phone:978-208-0527
Practice Address - Fax:978-208-1522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty