Provider Demographics
NPI:1720093594
Name:ONLINE ONTIME CHIROPRACTIC OF BOSTON, P.C.
Entity Type:Organization
Organization Name:ONLINE ONTIME CHIROPRACTIC OF BOSTON, P.C.
Other - Org Name:COMMONWEALTH CHIROPRACTIC OF BOSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:CRABTREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-739-0046
Mailing Address - Street 1:480 WASHINGTON ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2655
Mailing Address - Country:US
Mailing Address - Phone:617-739-0046
Mailing Address - Fax:617-738-9441
Practice Address - Street 1:480 WASHINGTON ST STE 201
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-739-0046
Practice Address - Fax:617-738-9441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1720093594OtherORGANIZATIONAL NPI