Provider Demographics
NPI:1679603864
Name:RAVINSKI, DEBORAH G (DC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:G
Last Name:RAVINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 STATE RD
Mailing Address - Street 2:STE 1
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7111
Mailing Address - Country:US
Mailing Address - Phone:508-833-6420
Mailing Address - Fax:508-833-6421
Practice Address - Street 1:2277 STATE RD
Practice Address - Street 2:STE 1
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7111
Practice Address - Country:US
Practice Address - Phone:508-833-6420
Practice Address - Fax:508-833-6421
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36187OtherBLUE CROSS BLUE SHIELD