Provider Demographics
NPI:1114191830
Name:CRETSINGER, DAVID WJ (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WJ
Last Name:CRETSINGER
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 1:1 OVERLOOK DR STE 7
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2800
Mailing Address - Country:US
Mailing Address - Phone:603-673-5600
Mailing Address - Fax:603-673-6688
Practice Address - Street 1:1 OVERLOOK DR STE 7
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2800
Practice Address - Country:US
Practice Address - Phone:603-673-5600
Practice Address - Fax:603-673-6688
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH240-0496111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHU61746Medicare UPIN
NHCR RE 4153Medicare PIN