Provider Demographics
NPI:1649340373
Name:SPENCER FAMILY CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:SPENCER FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-281-1411
Mailing Address - Street 1:321 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-4837
Mailing Address - Country:US
Mailing Address - Phone:978-281-1411
Mailing Address - Fax:978-281-2727
Practice Address - Street 1:321 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-4837
Practice Address - Country:US
Practice Address - Phone:978-281-1411
Practice Address - Fax:978-281-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA56825OtherHARVARD PILGRIM
MAY37052OtherBLUE CROSS
MAY39842OtherBLUE CROSS GROUP #
MAY37052OtherBLUE CROSS