Provider Demographics
NPI:1992944888
Name:LACHARITE CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:LACHARITE CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LACHARITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-490-7010
Mailing Address - Street 1:1681 CRANSTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-5000
Mailing Address - Country:US
Mailing Address - Phone:401-490-7010
Mailing Address - Fax:401-490-7011
Practice Address - Street 1:1681 CRANSTON ST.
Practice Address - Street 2:SUITE B
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-490-7010
Practice Address - Fax:401-490-7011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty