Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 1241 | MA |
NPI | 1245366053 |
---|---|
Provider Name | Dr. Gary Mark Crank |
First Address | Attleboro, MA 02703-4406 |
Second Address | Attleboro, MA 02703-5932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
408786 | B.C.B.S. RI (01) | MA |
4400799 | UNITED HEALTHCARE (01) | MA |
T38427 | (02) | MA |
Y36098 | B.C.B.S. MA (01) | MA |