Provider Demographics
NPI:1497061725
Name:PATH OF LIFE CHIROPRACTIC HEALTH CENTER, P.L.L.C.
Entity Type:Organization
Organization Name:PATH OF LIFE CHIROPRACTIC HEALTH CENTER, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-886-8300
Mailing Address - Street 1:25 MERRIT PKWY STE 4
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3078
Mailing Address - Country:US
Mailing Address - Phone:603-886-8300
Mailing Address - Fax:603-886-8302
Practice Address - Street 1:25 MERRIT PKWY STE 4
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3078
Practice Address - Country:US
Practice Address - Phone:603-886-8300
Practice Address - Fax:603-886-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH862-0310261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0024324OtherMEDICARE PTAN