Provider Demographics
NPI:1801128004
Name:RHEAUME, KEVIN A (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
Last Name:RHEAUME
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 1:10 UNION ST
Mailing Address - Street 2:STE 2C
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4759
Mailing Address - Country:US
Mailing Address - Phone:508-545-6789
Mailing Address - Fax:
Practice Address - Street 1:10 UNION ST
Practice Address - Street 2:STE 2C
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4759
Practice Address - Country:US
Practice Address - Phone:508-545-6789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5241564651111N00000X
MA3311111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA002097401OtherMEDICARE PTN