Provider Demographics
NPI:1356409015
Name:NETWORK CHIROPRACTIC OF ACTON PC
Entity type:Organization
Organization Name:NETWORK CHIROPRACTIC OF ACTON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-263-5182
Mailing Address - Street 1:22 ONEIDA RD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-2316
Mailing Address - Country:US
Mailing Address - Phone:978-263-5182
Mailing Address - Fax:978-274-1757
Practice Address - Street 1:22 ONEIDA RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-2316
Practice Address - Country:US
Practice Address - Phone:978-263-5182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA141858714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110140823AMedicaid
MAY39703OtherBLUE CROSS OF MA GROUP #