Organization
ADVANCED CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT JOHN DEGEORGE DC (OWNER)
(781) 233-7110
Entity
Organization
Contact information
Practice address
200 WALNUT ST, SAUGUS, MA 01906-1158
(781) 233-7110
(781) 233-9740
Mailing address
200 WALNUT STREET, SAUGUS, MA 01906
(781) 233-7110
(781) 233-9740
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y39331
BLUE CROSS BLUE SHIELD
MA
Enumeration date
06/07/2007
Last updated
08/22/2020
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