Provider Demographics
NPI:1467840249
Name:ASNC CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:ASNC CHIROPRACTIC PLLC
Other - Org Name:NEWPORT CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:HOLUSZKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-874-6727
Mailing Address - Street 1:104 JOHN STARK HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-2120
Mailing Address - Country:US
Mailing Address - Phone:603-863-6680
Mailing Address - Fax:
Practice Address - Street 1:104 JOHN STARK HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-2120
Practice Address - Country:US
Practice Address - Phone:603-863-6680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH955111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty