Provider Demographics
NPI:1932233277
Name:VILLAGE CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:VILLAGE CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:COSEGLIA
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:401-667-7700
Mailing Address - Street 1:55 BOSTON NECK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-5704
Mailing Address - Country:US
Mailing Address - Phone:401-667-7700
Mailing Address - Fax:401-667-7701
Practice Address - Street 1:55 BOSTON NECK RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-5704
Practice Address - Country:US
Practice Address - Phone:401-667-7700
Practice Address - Fax:401-667-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00453111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI672442OtherUNITED HEALTHCARE
RI275376OtherBLUE CROSS BLUE SHEILD
RI275376OtherBLUE CROSS BLUE SHEILD
RI299003543Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER