Provider Demographics
NPI:1700063955
Name:DUPILKA FAMILY CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:DUPILKA FAMILY CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:DUPILKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-745-6224
Mailing Address - Street 1:48 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5137
Mailing Address - Country:US
Mailing Address - Phone:978-745-6224
Mailing Address - Fax:
Practice Address - Street 1:48 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5137
Practice Address - Country:US
Practice Address - Phone:978-745-6224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1600770Medicaid
MA1600770Medicaid