Provider Demographics
NPI:1952456360
Name:MULCAHY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:MULCAHY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MULCAHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-457-0440
Mailing Address - Street 1:417 PALMER AVE
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2957
Mailing Address - Country:US
Mailing Address - Phone:508-457-0440
Mailing Address - Fax:508-457-1255
Practice Address - Street 1:417 PALMER AVE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2957
Practice Address - Country:US
Practice Address - Phone:508-457-0440
Practice Address - Fax:508-457-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA351439OtherHARVARD PILGRIM
MAY39561OtherBLUE CROSS-BLUE SHIELD
MAY49066Medicare ID - Type Unspecified
MAY39561OtherBLUE CROSS-BLUE SHIELD