Provider Demographics
NPI:1164471306
Name:GOFFSTOWN CHIROPRACTIC CARE, PLLC
Entity Type:Organization
Organization Name:GOFFSTOWN CHIROPRACTIC CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:N
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-384-1680
Mailing Address - Street 1:17A TATRO RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-2369
Mailing Address - Country:US
Mailing Address - Phone:603-384-1680
Mailing Address - Fax:603-384-1679
Practice Address - Street 1:17A TATRO RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-2369
Practice Address - Country:US
Practice Address - Phone:603-384-1680
Practice Address - Fax:603-384-1679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-06
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH538A0898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE8657Medicare PIN