Provider Demographics
NPI:1467063776
Name:GARDNER FAMILY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:GARDNER FAMILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-632-5885
Mailing Address - Street 1:123 WHITNEY ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3247
Mailing Address - Country:US
Mailing Address - Phone:978-632-5885
Mailing Address - Fax:978-630-3774
Practice Address - Street 1:123 WHITNEY ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3247
Practice Address - Country:US
Practice Address - Phone:978-632-5885
Practice Address - Fax:978-630-3774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
15021OtherFALLON
80705OtherONE HEALTH GREAT WEST
210035OtherACN ASHN
Y35953OtherBCBS
MA1609149Medicaid
750010OtherTUFTS HEALTHCARE
898687OtherFOCUS BEECH STREET
000000042790OtherBMC
1609149OtherMASS HEALTH
30700OtherCIGNA
986271OtherTUFTS NETWORK HEALTH
0013407OtherALLWAYS HEALTH PARTNERS
4481980OtherAETNA
OO13407OtherNEIGHBORHOOD
2045784OtherFIRST HEALTH CNN HCVM
351050OtherHARVARD PILGRIM
44-04224OtherUNITED HEALTHCARE