Provider Demographics
NPI:1316156136
Name:MCCAULEY CHIROPRACTIC CENTER, P.C.
Entity type:Organization
Organization Name:MCCAULEY CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCCAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:978-632-9500
Mailing Address - Street 1:31 LAKE ST
Mailing Address - Street 2:SUITE 151
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3879
Mailing Address - Country:US
Mailing Address - Phone:978-632-9500
Mailing Address - Fax:978-632-9579
Practice Address - Street 1:31 LAKE ST
Practice Address - Street 2:SUITE 151
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-3879
Practice Address - Country:US
Practice Address - Phone:978-632-9500
Practice Address - Fax:978-632-9579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU84954Medicare UPIN
MAY45422Medicare ID - Type Unspecified