Organization
CRANBERRY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWAYNE ROBERT HANNAM D.C. (PRESIDENT)
(508) 947-6455
Entity
Organization
Contact information
Practice address
205 W GROVE ST, SUITE D, MIDDLEBORO, MA 02346-1462
(508) 946-6455
(508) 947-6456
Mailing address
205 W GROVE ST, SUITE D, MIDDLEBORO, MA 02346-1462
(508) 946-6455
(508) 947-6456
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
25
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y39367
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/09/2007
Last updated
09/17/2010
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