Provider Demographics
NPI:1306220397
Name:DAVID R. LETELLIER, D.C.
Entity Type:Organization
Organization Name:DAVID R. LETELLIER, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:LETELLIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-623-6621
Mailing Address - Street 1:370 VARNEY ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-4138
Mailing Address - Country:US
Mailing Address - Phone:603-623-6621
Mailing Address - Fax:603-624-4540
Practice Address - Street 1:370 VARNEY ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-4138
Practice Address - Country:US
Practice Address - Phone:603-623-6621
Practice Address - Fax:603-624-4540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH338-A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty