Individual
JAMAL THOMAS DE VITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
179 GREAT RD STE 107, ACTON, MA 01720-5740
(978) 263-9336
(978) 264-4431
Mailing address
179 GREAT RD STE 107, ACTON, MA 01720-5740
(978) 263-9336
(978) 264-4431
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3001
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1603370
—
MA
Enumeration date
05/20/2006
Last updated
05/06/2020
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