| NPI | 1972378438 |
|---|---|
| Doing Business As | MODERN CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | PHILIP DEVASTO Owner 617-365-1527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-15 |