Provider Demographics
NPI:1649306572
Name:MARCEAU CHIROPRACTIC & REHAB, LLC
Entity type:Organization
Organization Name:MARCEAU CHIROPRACTIC & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOROWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARCEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-675-7246
Mailing Address - Street 1:167 SWANSEA MALL DR
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4102
Mailing Address - Country:US
Mailing Address - Phone:508-675-7246
Mailing Address - Fax:508-673-9073
Practice Address - Street 1:167 SWANSEA MALL DR
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4102
Practice Address - Country:US
Practice Address - Phone:508-675-7246
Practice Address - Fax:508-673-9073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH2096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2634582OtherAETNA
MA689478OtherTUFTS HEALTH PLAN
MA350166OtherHARVARD PILGRIM
MAY39471OtherBLUE CROSS BLUE SHIELD
MA350166OtherHARVARD PILGRIM