1871864256 NPI number — SPRINGFIELD FAMILY CHIROPRACTIC LLC.

Table of content: (NPI 1871864256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871864256 NPI number — SPRINGFIELD FAMILY CHIROPRACTIC LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPRINGFIELD FAMILY CHIROPRACTIC LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871864256
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3091
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01101-3091
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-335-2558
Provider Business Mailing Address Fax Number:
866-711-9657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
281 STATE ST
Provider Second Line Business Practice Location Address:
STE 1F
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01103-1997
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-335-2558
Provider Business Practice Location Address Fax Number:
866-711-9657
Provider Enumeration Date:
01/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
DION
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
JEFFREY
Authorized Official Title or Position:
CEO/OWNER/CHIROPRACTIC PHYSICIAN
Authorized Official Telephone Number:
413-335-2558

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  3354 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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