Provider Demographics
NPI:1942741616
Name:NEW ENGLAND CHIROPRACTIC & SPORTS HEALTH
Entity Type:Organization
Organization Name:NEW ENGLAND CHIROPRACTIC & SPORTS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:MOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-335-3445
Mailing Address - Street 1:132 OLD RIVER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1161
Mailing Address - Country:US
Mailing Address - Phone:401-335-3445
Mailing Address - Fax:401-633-6494
Practice Address - Street 1:132 OLD RIVER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1161
Practice Address - Country:US
Practice Address - Phone:401-335-3445
Practice Address - Fax:401-633-6494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty