Provider Demographics
NPI:1073591442
Name:ALLEN, LOYALL C (DC)
Entity Type:Individual
Prefix:DR
First Name:LOYALL
Middle Name:C
Last Name:ALLEN
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:PO BOX 55
Mailing Address - Street 2:4 HENNIKER STREET SUITE A
Mailing Address - City:HILLSBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03244-0055
Mailing Address - Country:US
Mailing Address - Phone:603-464-3303
Mailing Address - Fax:603-464-3433
Practice Address - Street 1:4 HENNIKER ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:NH
Practice Address - Zip Code:03244-5528
Practice Address - Country:US
Practice Address - Phone:603-464-3303
Practice Address - Fax:603-464-3433
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0010689-R111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30003264Medicaid
NHALRE7647Medicare ID - Type UnspecifiedMEDICARE