Provider Demographics
NPI:1275602104
Name:PATIENT FIRST CHIROPRACTIC AND PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:PATIENT FIRST CHIROPRACTIC AND PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:CADDOO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-894-8880
Mailing Address - Street 1:564 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452
Mailing Address - Country:US
Mailing Address - Phone:781-894-8880
Mailing Address - Fax:781-894-1121
Practice Address - Street 1:564 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452
Practice Address - Country:US
Practice Address - Phone:781-894-8880
Practice Address - Fax:781-894-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty