Provider Demographics
NPI:1679745715
Name:ACCESS FAMILY CHIROPRACTIC INC.
Entity type:Organization
Organization Name:ACCESS FAMILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:413-733-1181
Mailing Address - Street 1:770 CAREW ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-1948
Mailing Address - Country:US
Mailing Address - Phone:413-733-1181
Mailing Address - Fax:413-733-6676
Practice Address - Street 1:770 CAREW ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-1948
Practice Address - Country:US
Practice Address - Phone:413-733-1181
Practice Address - Fax:413-733-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1960111N00000X
CT001876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9725181Medicaid
MA9725181Medicaid