Provider Demographics
NPI:1275931057
Name:VANASSELBERG, DESIREE SHELBY (DC)
Entity Type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:SHELBY
Last Name:VANASSELBERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 VILLAGE RD UNIT 13B
Mailing Address - Street 2:
Mailing Address - City:PEPPERELL
Mailing Address - State:MA
Mailing Address - Zip Code:01463-1182
Mailing Address - Country:US
Mailing Address - Phone:603-315-5122
Mailing Address - Fax:
Practice Address - Street 1:1 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:PEPPERELL
Practice Address - State:MA
Practice Address - Zip Code:01463-1504
Practice Address - Country:US
Practice Address - Phone:978-433-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH959111N00000X
MACHI3685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor