Provider Demographics
NPI:1851721914
Name:CALHOUN CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:CALHOUN CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STANTON
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-681-4500
Mailing Address - Street 1:451 ANDOVER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5044
Mailing Address - Country:US
Mailing Address - Phone:978-681-4500
Mailing Address - Fax:978-420-4414
Practice Address - Street 1:451 ANDOVER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5044
Practice Address - Country:US
Practice Address - Phone:978-681-4500
Practice Address - Fax:978-420-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-26
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1235230947OtherINDIVIIDUAL NPI
MA110073246/AMedicaid
MAY45837OtherMEDICARE PTAN/LEGACY