Provider Demographics
NPI:1194887794
Name:ADAMS, ELISA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 ELSINORE ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2315
Mailing Address - Country:US
Mailing Address - Phone:978-369-1881
Mailing Address - Fax:978-369-8912
Practice Address - Street 1:16 CLARKE ST
Practice Address - Street 2:SUITE 16
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-4988
Practice Address - Country:US
Practice Address - Phone:781-674-2500
Practice Address - Fax:978-369-8912
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35570OtherBCBSMA
MAY35570OtherBCBSMA