Provider Demographics
NPI:1679710891
Name:CIRCLE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CIRCLE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-993-9936
Mailing Address - Street 1:26 BRIGHTON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-4043
Mailing Address - Country:US
Mailing Address - Phone:617-993-9936
Mailing Address - Fax:617-993-9938
Practice Address - Street 1:26 BRIGHTON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-4043
Practice Address - Country:US
Practice Address - Phone:617-993-9936
Practice Address - Fax:617-993-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty