Provider Demographics
NPI:1013128404
Name:SOLEY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:SOLEY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-562-3615
Mailing Address - Street 1:PO BOX 890
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MA
Mailing Address - Zip Code:01033-0890
Mailing Address - Country:US
Mailing Address - Phone:413-569-9188
Mailing Address - Fax:413-569-6493
Practice Address - Street 1:70 COURT ST STE 1
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3521
Practice Address - Country:US
Practice Address - Phone:413-562-3615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY49010Medicare ID - Type Unspecified