Provider Demographics
NPI:1366940231
Name:CHIROPRACTIC NATURALLY, INC.
Entity type:Organization
Organization Name:CHIROPRACTIC NATURALLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARSELLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:IMONTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:857-273-4162
Mailing Address - Street 1:337 BELGRADE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-2757
Mailing Address - Country:US
Mailing Address - Phone:857-273-4162
Mailing Address - Fax:857-273-3946
Practice Address - Street 1:337 BELGRADE AVE
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-2757
Practice Address - Country:US
Practice Address - Phone:857-273-4162
Practice Address - Fax:857-273-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty