Provider Demographics
NPI:1447683529
Name:WINCHESTER FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:WINCHESTER FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-210-1454
Mailing Address - Street 1:10 CONVERSE PL
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2713
Mailing Address - Country:US
Mailing Address - Phone:413-210-1454
Mailing Address - Fax:
Practice Address - Street 1:10 CONVERSE PL
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2713
Practice Address - Country:US
Practice Address - Phone:413-210-1454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3379111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ139853Medicare PIN