Provider Demographics
NPI:1457794984
Name:GRACA, CELINA (DC)
Entity Type:Individual
Prefix:DR
First Name:CELINA
Middle Name:
Last Name:GRACA
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:PO BOX 572
Mailing Address - Street 2:
Mailing Address - City:EAST FREETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02717-0572
Mailing Address - Country:US
Mailing Address - Phone:774-328-5698
Mailing Address - Fax:
Practice Address - Street 1:8 CROSSROADS DR
Practice Address - Street 2:
Practice Address - City:EAST FREETOWN
Practice Address - State:MA
Practice Address - Zip Code:02717-1256
Practice Address - Country:US
Practice Address - Phone:774-328-5698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3415111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor