Provider Demographics
NPI:1700916459
Name:CHESLOCK, ERIN L (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:L
Last Name:CHESLOCK
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 1:211 COUNTRY WAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-3718
Mailing Address - Country:US
Mailing Address - Phone:508-580-2225
Mailing Address - Fax:508-580-8898
Practice Address - Street 1:47 W ELM ST
Practice Address - Street 2:SUITE 208
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4332
Practice Address - Country:US
Practice Address - Phone:508-580-2225
Practice Address - Fax:508-580-8898
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA12912OtherHPHC NUMBER
MAY36452OtherBCBS INDEMNITY NUMBER
MAY36452Medicare ID - Type Unspecified