Provider Demographics
NPI:1689714180
Name:AERIE CHIROPRACTIC LTD PC
Entity Type:Organization
Organization Name:AERIE CHIROPRACTIC LTD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ESPERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-548-7722
Mailing Address - Street 1:433 TEATICKET HWY
Mailing Address - Street 2:
Mailing Address - City:TEATICKET
Mailing Address - State:MA
Mailing Address - Zip Code:02536-6545
Mailing Address - Country:US
Mailing Address - Phone:508-548-7722
Mailing Address - Fax:508-548-7722
Practice Address - Street 1:433 TEATICKET HWY
Practice Address - Street 2:
Practice Address - City:TEATICKET
Practice Address - State:MA
Practice Address - Zip Code:02536-6545
Practice Address - Country:US
Practice Address - Phone:508-548-7722
Practice Address - Fax:508-548-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35935OtherHARVARD PILGRIM
MAAEY39047OtherBCBS OF MASS