Provider Demographics
NPI:1831383926
Name:DIENER, ERIC ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROBERT
Last Name:DIENER
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 1:995 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-1928
Mailing Address - Country:US
Mailing Address - Phone:781-337-7777
Mailing Address - Fax:
Practice Address - Street 1:995 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-1928
Practice Address - Country:US
Practice Address - Phone:781-337-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACH2162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor