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Organization
RIVERSIDE CHIROPRACTIC WELLNESS CENTERS, INC
Active
Organization
RIVERSIDE CHIROPRACTIC WELLNESS CENTERS, INC
Active
Other names
Riverside Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REZA POURSHADI DC (PRESIDENT)
(781) 395-0003
Entity
Organization
Contact information
Practice address
65 RIVERSIDE AVE STE C, MEDFORD, MA 02155-4653
(781) 395-0003
(781) 395-2223
Mailing address
181 TAFT RD, WILMINGTON, MA 01887-2820
(781) 395-0003
(781) 395-2223
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2413
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697218
—
MA
Enumeration date
06/25/2012
Last updated
06/25/2012
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