Provider Demographics
NPI:1740369859
Name:GELINEAU, DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:GELINEAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1533 LAKEVIEW AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3324
Mailing Address - Country:US
Mailing Address - Phone:978-453-2792
Mailing Address - Fax:
Practice Address - Street 1:1533 LAKEVIEW AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-3324
Practice Address - Country:US
Practice Address - Phone:978-453-2792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU97504Medicare UPIN
MAGEY45669Medicare ID - Type Unspecified