Provider Demographics
NPI:1801193412
Name:COHASSET FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:COHASSET FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-923-1226
Mailing Address - Street 1:814 CHIEF JUSTICE CUSHING HWY
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-2118
Mailing Address - Country:US
Mailing Address - Phone:781-923-1226
Mailing Address - Fax:781-923-1228
Practice Address - Street 1:814 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-2118
Practice Address - Country:US
Practice Address - Phone:781-923-1226
Practice Address - Fax:781-923-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA809111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty