Provider Demographics
NPI:1063448777
Name:BIGELOW, BRIAN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:THOMAS
Last Name:BIGELOW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 EVE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-1520
Mailing Address - Country:US
Mailing Address - Phone:603-315-0283
Mailing Address - Fax:603-883-0157
Practice Address - Street 1:155 MAIN DUNSTABLE RD
Practice Address - Street 2:SUITE 135
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3640
Practice Address - Country:US
Practice Address - Phone:603-883-8971
Practice Address - Fax:603-883-0157
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2851087A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor