Integrative Chiropractic and Rehabilitation, P. C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

521 Issued in MA

Legal business name

INTEGRATIVE CHIROPRACTIC AND REHABILITATION, P. C.

Practice address

42 Diauto Dr
Randolph, MA 02368-4510

Phone

(781) 986-6443

Fax

(781) 986-4837

NPI assigned

Mar 23, 2006

Organization subpart

No

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

Authorized official

Name

Mark Klezmer, DC

Title

Owner

Phone

(781) 986-6443

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972562288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 DIAUTO DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684510",
            "telephone_number": "781-986-6443",
            "fax_number": "781-986-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 DIAUTO DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684510",
            "telephone_number": "781-986-6443",
            "fax_number": "781-986-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE CHIROPRACTIC AND REHABILITATION, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KLEZMER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-986-6443",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y39771",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.