Provider Demographics
NPI:1649315730
Name:BERTRAND, ALBERT LOUIS (DC)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:LOUIS
Last Name:BERTRAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73A WINTHROP AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-3716
Mailing Address - Country:US
Mailing Address - Phone:978-685-1566
Mailing Address - Fax:978-687-0170
Practice Address - Street 1:73A WINTHROP AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-3716
Practice Address - Country:US
Practice Address - Phone:978-685-1566
Practice Address - Fax:978-687-0170
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor