Provider Demographics
NPI:1770658809
Name:CHIROPRACTIC HEALTH CENTER LLP
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PENTLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-234-8284
Mailing Address - Street 1:800 PROVIDENCE ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-2125
Mailing Address - Country:US
Mailing Address - Phone:508-234-8222
Mailing Address - Fax:508-234-7558
Practice Address - Street 1:800 PROVIDENCE ROAD
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-2125
Practice Address - Country:US
Practice Address - Phone:508-234-8222
Practice Address - Fax:508-234-7558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
35461OtherHARVARD PILGRIM
722474OtherTUFTS
35461OtherHARVARD PILGRIM
T57942Medicare UPIN