Provider Demographics
NPI:1407889231
Name:FINNEGAN, MICHAEL T (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:FINNEGAN
Suffix:
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 1:546 MILL ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-2445
Mailing Address - Country:US
Mailing Address - Phone:508-791-4677
Mailing Address - Fax:508-791-4907
Practice Address - Street 1:546 MILL ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-2445
Practice Address - Country:US
Practice Address - Phone:508-791-4677
Practice Address - Fax:508-791-4907
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2059111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45156Medicare ID - Type Unspecified