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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