Provider Demographics
NPI:1295432037
Name:EVERETT CHIROPRACTIC LLC
Entity type:Organization
Organization Name:EVERETT CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:LEAHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:617-389-6951
Mailing Address - Street 1:107 FERRY STREET
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-4940
Mailing Address - Country:US
Mailing Address - Phone:617-389-6951
Mailing Address - Fax:617-389-2934
Practice Address - Street 1:107 FERRY STREET
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-4940
Practice Address - Country:US
Practice Address - Phone:617-389-6951
Practice Address - Fax:617-389-2934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty