Provider Demographics
NPI:1013185727
Name:POWER OF ONE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:POWER OF ONE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:KNOWLTON
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-673-6133
Mailing Address - Street 1:51 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4810
Mailing Address - Country:US
Mailing Address - Phone:603-673-6133
Mailing Address - Fax:603-673-6144
Practice Address - Street 1:51 ELM ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4810
Practice Address - Country:US
Practice Address - Phone:603-673-6133
Practice Address - Fax:603-673-6144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH775-1106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1073630976OtherTYPE 1 NPI #