Provider Demographics
NPI:1649534678
Name:KIERANS, CUISLE (DC)
Entity type:Individual
Prefix:
First Name:CUISLE
Middle Name:
Last Name:KIERANS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OLD FARM WAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01951-1732
Mailing Address - Country:US
Mailing Address - Phone:978-518-2799
Mailing Address - Fax:
Practice Address - Street 1:20 OLD FARM WAY
Practice Address - Street 2:
Practice Address - City:NEWBURY
Practice Address - State:MA
Practice Address - Zip Code:01951-1732
Practice Address - Country:US
Practice Address - Phone:978-518-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11100000X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3370OtherMA LICENSE