Provider Demographics
NPI:1861109852
Name:911 CHIROPRACTIC LLC
Entity type:Organization
Organization Name:911 CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYER/EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:EDMUND
Authorized Official - Last Name:SCRIMA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:617-913-3256
Mailing Address - Street 1:800 W CUMMINGS PARK STE 5600
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6393
Mailing Address - Country:US
Mailing Address - Phone:617-644-0911
Mailing Address - Fax:
Practice Address - Street 1:800 W CUMMINGS PARK STE 5600
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6393
Practice Address - Country:US
Practice Address - Phone:617-644-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty