Boston Gonstead Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3524 Issued in MA

Legal business name

BOSTON GONSTEAD CHIROPRACTIC LLC

Practice address

77 Pond Ave Ste 101
Brookline, MA 02445-7115

Phone

(617) 277-0648

Fax

(617) 277-0696

NPI assigned

Oct 11, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeongho Yoo, D.C.

Title

Owner

Phone

(617) 277-0648

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1831649128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 POND AVE STE 101",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457115",
            "telephone_number": "617-277-0648",
            "fax_number": "617-277-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 POND AVE STE 101",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457115",
            "telephone_number": "617-277-0648",
            "fax_number": "617-277-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON GONSTEAD CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "JEONGHO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-277-0648",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Brookline, MA
• Providers in Brookline, MA by specialty
• Chiropractor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.