Provider Demographics
NPI:1649464793
Name:EATON CHIROPRACTIC INC
Entity type:Organization
Organization Name:EATON CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:F
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-823-2697
Mailing Address - Street 1:109 DEAN STREET
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2717
Mailing Address - Country:US
Mailing Address - Phone:508-823-2697
Mailing Address - Fax:508-824-4559
Practice Address - Street 1:109 DEAN STREET
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2717
Practice Address - Country:US
Practice Address - Phone:508-823-2697
Practice Address - Fax:508-824-4559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH 37CF111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2329777OtherAETNA
MA351312OtherHARVARD PILGRIM
MAY39397OtherBLUE CROSS
MA776828OtherTUFTS
MA351312OtherHARVARD PILGRIM