Provider Demographics
NPI:1093312423
Name:PELHAM FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:PELHAM FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-312-3464
Mailing Address - Street 1:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-0939
Mailing Address - Country:US
Mailing Address - Phone:603-635-2642
Mailing Address - Fax:603-635-8116
Practice Address - Street 1:71 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NH
Practice Address - Zip Code:03076-3479
Practice Address - Country:US
Practice Address - Phone:603-635-2642
Practice Address - Fax:603-635-8116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1700367653OtherNPI
1568927259OtherNPI