Provider Demographics
NPI:1316097025
Name:PERRAS, ROBERT JOSEPH JR (DC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:PERRAS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:404 MIDDLESEX RD
Mailing Address - Street 2:#3
Mailing Address - City:TYNGSBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01879-1067
Mailing Address - Country:US
Mailing Address - Phone:978-649-5777
Mailing Address - Fax:978-649-5777
Practice Address - Street 1:404 MIDDLESEX RD
Practice Address - Street 2:#3
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879-1067
Practice Address - Country:US
Practice Address - Phone:978-649-5777
Practice Address - Fax:978-649-5777
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2012-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA1985111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1697196Medicaid
MA1697196Medicaid