Provider Demographics
NPI:1740475565
Name:METRO-WEST NEUROLOGICAL AND MUSCULOSKELETAL ASSOCIATES MANAGEMENT CORP
Entity type:Organization
Organization Name:METRO-WEST NEUROLOGICAL AND MUSCULOSKELETAL ASSOCIATES MANAGEMENT CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:MULHERN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-891-8388
Mailing Address - Street 1:88 MAPLE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-4471
Mailing Address - Country:US
Mailing Address - Phone:781-891-8388
Mailing Address - Fax:781-894-2866
Practice Address - Street 1:88 MAPLE ST
Practice Address - Street 2:SUITE A
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-4471
Practice Address - Country:US
Practice Address - Phone:781-891-8388
Practice Address - Fax:781-894-2866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY39315Medicare PIN