Provider Demographics
NPI:1912931841
Name:AUSSANT, TERRANCE GARTH (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:GARTH
Last Name:AUSSANT
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 1:175 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2225
Mailing Address - Country:US
Mailing Address - Phone:508-431-2920
Mailing Address - Fax:508-431-2925
Practice Address - Street 1:175 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2225
Practice Address - Country:US
Practice Address - Phone:508-431-2520
Practice Address - Fax:508-431-2925
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP 00521111N00000X
MA2877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1050734OtherAMERICAN SPECIALTY HEALTH
291965OtherBCBS OF RI
3564893OtherAETNA
664484OtherACN
043379412OtherLANDMARK
AA20597OtherHARVARD PILGRIM
7256986OtherCIGNA
043379412OtherPHCS
Y39819OtherBCBS OF MA
291965OtherBCBS OF RI
AA20597OtherHARVARD PILGRIM