Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 629 | MA |
NPI | 1154380087 |
---|---|
Provider Name | Dr. Richard Michael Danubio |
First Address | Peabody, MA 01960-1385 |
Second Address | Peabody, MA 01960-1385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 25/03/2013 |