Provider Demographics
NPI:1265571079
Name:MASZTAL, DAVID STANLEY (DC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:STANLEY
Last Name:MASZTAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MOODY STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1269
Mailing Address - Country:US
Mailing Address - Phone:413-589-9006
Mailing Address - Fax:413-589-7002
Practice Address - Street 1:100 MOODY STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-1269
Practice Address - Country:US
Practice Address - Phone:413-589-9006
Practice Address - Fax:413-589-7002
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH1378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35919OtherBCBS
MAY35919OtherBCBS