Provider Demographics
NPI:1356796486
Name:NORTH RIVER FAMILY CHIROPRACTIC, PC
Entity type:Organization
Organization Name:NORTH RIVER FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:BAXTER
Authorized Official - Last Name:WADEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:7817-409-4984
Mailing Address - Street 1:195 WHITING ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3717
Mailing Address - Country:US
Mailing Address - Phone:781-740-9494
Mailing Address - Fax:
Practice Address - Street 1:195 WHITING ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-3717
Practice Address - Country:US
Practice Address - Phone:781-740-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty