Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH 1945 | MA |
NPI | 1265587745 |
---|---|
Provider Name | Dr. Carol Lynn Defranca |
First Address | Norwell, MA 02061-1712 |
Second Address | Norwell, MA 02061-1712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Y36400 | BLUE CROSS PROVIDER ID (01) | MA |