Provider Demographics
NPI:1417138553
Name:RONCHETTI, CHARLES J (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:J
Last Name:RONCHETTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MANCHESTER RD.
Mailing Address - Street 2:#7
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038
Mailing Address - Country:US
Mailing Address - Phone:603-437-0400
Mailing Address - Fax:603-437-0443
Practice Address - Street 1:35 MANCHESTER RD.
Practice Address - Street 2:#7
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038
Practice Address - Country:US
Practice Address - Phone:603-437-0400
Practice Address - Fax:603-437-0443
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2109111N00000X
NH887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor