Provider Demographics
NPI:1992922017
Name:ROAN FAMILY CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:ROAN FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-230-2323
Mailing Address - Street 1:105 WASHINGTON ST
Mailing Address - Street 2:SUITE #4
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1100
Mailing Address - Country:US
Mailing Address - Phone:508-230-2323
Mailing Address - Fax:508-230-8223
Practice Address - Street 1:105 WASHINGTON ST
Practice Address - Street 2:SUITE #4
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1100
Practice Address - Country:US
Practice Address - Phone:508-230-2323
Practice Address - Fax:508-230-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty