Provider Demographics
NPI:1770579831
Name:TRITOWN CHIROPRACTIC OFFICES PC
Entity type:Organization
Organization Name:TRITOWN CHIROPRACTIC OFFICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:C
Authorized Official - Last Name:MACEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-698-0688
Mailing Address - Street 1:211 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1045
Mailing Address - Country:US
Mailing Address - Phone:508-698-0688
Mailing Address - Fax:508-698-0621
Practice Address - Street 1:211 NORTH ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1045
Practice Address - Country:US
Practice Address - Phone:508-698-0688
Practice Address - Fax:508-698-0621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0004524Medicare PIN
RI709004014Medicare PIN