Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CH1621 | MA |
NPI | 1205810595 |
---|---|
Provider Name | Dr. James Paul Barassi |
First Address | Leominster, MA 01453-4397 |
Second Address | Leominster, MA 01453-4397 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 11/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U27130 | (02) | MA |