Provider Demographics
NPI:1467602011
Name:ARSENAULT FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:ARSENAULT FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARSENAULT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-964-1460
Mailing Address - Street 1:29 LAFAYETTE RD
Mailing Address - Street 2:PO BOX 366
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2436
Mailing Address - Country:US
Mailing Address - Phone:603-964-1460
Mailing Address - Fax:
Practice Address - Street 1:29 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2436
Practice Address - Country:US
Practice Address - Phone:603-964-1460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH200-495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0505700Y0NH02OtherBLUE CROSS BLUE SHIELD NEW HAMPSHIRE
NH0505700Y0NH02OtherBLUE CROSS BLUE SHIELD NEW HAMPSHIRE