Provider Demographics
NPI:1720549439
Name:DEGRE CHIROPRACTIC OF LYNN
Entity Type:Organization
Organization Name:DEGRE CHIROPRACTIC OF LYNN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-459-0778
Mailing Address - Street 1:225 BOSTON ST STE 206
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904-3124
Mailing Address - Country:US
Mailing Address - Phone:781-215-6147
Mailing Address - Fax:
Practice Address - Street 1:225 BOSTON ST STE 206
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-3124
Practice Address - Country:US
Practice Address - Phone:781-215-6147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service