Provider Demographics
NPI:1033453105
Name:HANOVER FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:HANOVER FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D ARCY
Authorized Official - Last Name:MUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-643-2200
Mailing Address - Street 1:68 LYME RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1212
Mailing Address - Country:US
Mailing Address - Phone:603-643-2200
Mailing Address - Fax:603-643-4931
Practice Address - Street 1:68 LYME RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1212
Practice Address - Country:US
Practice Address - Phone:603-643-2200
Practice Address - Fax:603-643-4931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1501093A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty