Provider Demographics
NPI:1316900426
Name:NOLAN, WILLIAM RICHARD JR (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:NOLAN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2880
Mailing Address - Country:US
Mailing Address - Phone:978-774-4468
Mailing Address - Fax:978-225-0951
Practice Address - Street 1:15 CHERRY ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2880
Practice Address - Country:US
Practice Address - Phone:978-774-4468
Practice Address - Fax:978-225-0951
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor