Daniel Ceballos

Individual provider Active NPI Chiropractor · Southbridge, MA

NPI 1639628555 · NPPES record last updated Sep 27, 2021

Key facts

NPI
1639628555
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
3552 (MA)
Practice address
22 Goddard St
Southbridge, MA 01550-2482
Phone
(508) 505-5155
NPI assigned
Oct 4, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
3552MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Michael Darr DC Chiropractor Past
since Sep 20, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3552 MA Yes

Addresses

Primary practice location

22 Goddard St
Southbridge, MA 01550-2482

Mailing address

155 Northland Dr
Medina, OH 44256-1534
Phone (330) 723-1441

Other providers in Southbridge, MA

All providers in Southbridge, MA · Chiropractor in Massachusetts

Sources for this page

Verify at the official NPI Registry.