Organization
SBR SPORTS CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA JANSEN D.C (OWNER/CHIROPRACTOR)
(617) 930-6205
Entity
Organization
Contact information
Practice address
151 MYSTIC AVE, SUITE 1, MEDFORD, MA 02155-4632
(617) 930-6205
Mailing address
151 MYSTIC AVE, SUITE 1, MEDFORD, MA 02155-4632
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3186
MA
Other
Enumeration date
12/07/2011
Last updated
12/28/2011
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