Provider Demographics
NPI:1922137710
Name:PAYTON, TERI L (DC)
Entity Type:Individual
Prefix:
First Name:TERI
Middle Name:L
Last Name:PAYTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-4005
Mailing Address - Country:US
Mailing Address - Phone:978-556-0313
Mailing Address - Fax:978-373-7338
Practice Address - Street 1:57 WINGATE ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-5722
Practice Address - Country:US
Practice Address - Phone:978-372-7008
Practice Address - Fax:978-372-7335
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPA-Y35975Medicare ID - Type Unspecified
MAT38987Medicare UPIN