Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH2100 | MA |
NPI | 1003953498 |
---|---|
Provider Name | Dr. Scott J Diamond |
First Address | Boston, MA 02116-3374 |
Second Address | Boston, MA 02116-3374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 17/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U80424 | (02) | MA |