Provider Demographics
NPI:1013435981
Name:DR ANDREY OKHRIMENKO FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:DR ANDREY OKHRIMENKO FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:OKHRIMENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-331-5023
Mailing Address - Street 1:53 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-2624
Mailing Address - Country:US
Mailing Address - Phone:413-331-5023
Mailing Address - Fax:413-331-5024
Practice Address - Street 1:53 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013
Practice Address - Country:US
Practice Address - Phone:413-331-5023
Practice Address - Fax:413-331-5024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3410111N00000X, 111NN1001X, 111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NT0100XChiropractic ProvidersChiropractorThermographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA=========Medicaid