Provider Demographics
NPI:1457543282
Name:SOUTH SHORE CHIROPRACTIC CARE, P.C.
Entity Type:Organization
Organization Name:SOUTH SHORE CHIROPRACTIC CARE, P.C.
Other - Org Name:HEALTH SOLUTIONS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DCDABCO
Authorized Official - Phone:781-659-7989
Mailing Address - Street 1:353 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1903
Mailing Address - Country:US
Mailing Address - Phone:781-659-7989
Mailing Address - Fax:
Practice Address - Street 1:353 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1903
Practice Address - Country:US
Practice Address - Phone:781-659-7989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA591111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAT58158Medicare UPIN