Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 722 | MA |
NPI | 1114088002 |
---|---|
Provider Name | Dr. Joseph L King |
First Address | Wakefield, MA 01880-1309 |
Second Address | Wakefield, MA 01880-1309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |