Provider Demographics
NPI:1851701619
Name:BIG CITY CHIROPRACTIC & SPORTS INJURY
Entity Type:Organization
Organization Name:BIG CITY CHIROPRACTIC & SPORTS INJURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-533-8902
Mailing Address - Street 1:1855 DORCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2426
Mailing Address - Country:US
Mailing Address - Phone:617-533-8902
Mailing Address - Fax:617-533-7814
Practice Address - Street 1:1855 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-2426
Practice Address - Country:US
Practice Address - Phone:617-533-8902
Practice Address - Fax:617-533-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1417008665OtherNPI