Provider Demographics
NPI:1750766440
Name:OLIVIERI CHIROPRACTIC & SPORTS MEDICINE, INC
Entity type:Organization
Organization Name:OLIVIERI CHIROPRACTIC & SPORTS MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-664-3769
Mailing Address - Street 1:211 LINCOLN ST
Mailing Address - Street 2:C/O REEBOK CROSSFIT BARE COVE
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1700
Mailing Address - Country:US
Mailing Address - Phone:781-664-3769
Mailing Address - Fax:781-754-1484
Practice Address - Street 1:211 LINCOLN ST
Practice Address - Street 2:C/O REEBOK CROSSFIT BARE COVE
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1700
Practice Address - Country:US
Practice Address - Phone:781-664-3769
Practice Address - Fax:781-754-1484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty