Provider Demographics
NPI:1134792427
Name:PRECISION CHIROPRACTIC, INC
Entity type:Organization
Organization Name:PRECISION CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MEDEIROS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-459-6780
Mailing Address - Street 1:1268 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-1413
Mailing Address - Country:US
Mailing Address - Phone:401-459-6780
Mailing Address - Fax:401-459-6783
Practice Address - Street 1:1268 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1413
Practice Address - Country:US
Practice Address - Phone:401-459-6780
Practice Address - Fax:401-459-6783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDCP00545OtherMEDICAL LICENSURE