Provider Demographics
NPI:1861089260
Name:STADIUM CHIROPRACTIC PC
Entity type:Organization
Organization Name:STADIUM CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARMANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-327-5571
Mailing Address - Street 1:2 D'URSO AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843
Mailing Address - Country:US
Mailing Address - Phone:978-420-2221
Mailing Address - Fax:
Practice Address - Street 1:2 D'URSO AVENUE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843
Practice Address - Country:US
Practice Address - Phone:978-420-2221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty