Provider Demographics
NPI:1154503415
Name:MCQUEENEY CHIROPRACTIC & PHYSICAL THERAPY CENTER
Entity Type:Organization
Organization Name:MCQUEENEY CHIROPRACTIC & PHYSICAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCQUEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-778-2919
Mailing Address - Street 1:9 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4807
Mailing Address - Country:US
Mailing Address - Phone:603-778-2919
Mailing Address - Fax:603-778-9051
Practice Address - Street 1:9 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4807
Practice Address - Country:US
Practice Address - Phone:603-778-2919
Practice Address - Fax:603-778-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0922225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80009727Medicaid
NHT25862Medicare UPIN