Provider Demographics
NPI:1407240179
Name:SPINAL ORTHOPEDIC CHIROPRACTIC HEALTH CENTER, PLLC
Entity Type:Organization
Organization Name:SPINAL ORTHOPEDIC CHIROPRACTIC HEALTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMN
Authorized Official - Prefix:MRS
Authorized Official - First Name:GUYLAINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ARAGONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-494-7804
Mailing Address - Street 1:132 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2512
Mailing Address - Country:US
Mailing Address - Phone:603-669-0687
Mailing Address - Fax:603-249-5729
Practice Address - Street 1:132 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2512
Practice Address - Country:US
Practice Address - Phone:603-669-0687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH558A111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHU33042Medicare UPIN