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Organization
CHARLES STREET FAMILY CHIROPRACTIC, INC
Active
Organization
CHARLES STREET FAMILY CHIROPRACTIC, INC
Active
Other names
Charles Street Family Chiropractic & Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIANA CELESIA RD (OFFICE MANAGER)
(617) 720-1992
Entity
Organization
Contact information
Practice address
102 CHARLES ST, BOSTON, MA 02114-4607
(617) 720-1992
(617) 248-9916
Mailing address
102 CHARLES ST, BOSTON, MA 02114-4607
(617) 720-1992
(617) 248-9916
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
222
MA
133V00000X
Registered Dietitian
—
—
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4258513
AETNA
—
01
—
5190774
CIGNA GROUP NUMBER
—
01
—
641432
TUFTS GROUP NUMBER
—
01
—
Y39316
BCBS GROUP NUMBER
MA
Enumeration date
07/24/2006
Last updated
04/01/2025
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