Provider Demographics
NPI:1235439852
Name:ATLANTIC CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:ATLANTIC CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-422-3387
Mailing Address - Street 1:100 ISLINGTON ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4263
Mailing Address - Country:US
Mailing Address - Phone:603-436-9229
Mailing Address - Fax:
Practice Address - Street 1:100 ISLINGTON ST
Practice Address - Street 2:SUITE 7
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4263
Practice Address - Country:US
Practice Address - Phone:603-436-9229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH07206520481A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty