Provider Demographics
NPI:1578021283
Name:PAULSON, TORY OPAL (DC)
Entity Type:Individual
Prefix:
First Name:TORY
Middle Name:OPAL
Last Name:PAULSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 LYME RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-1212
Mailing Address - Country:US
Mailing Address - Phone:603-643-2200
Mailing Address - Fax:
Practice Address - Street 1:68 LYME RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-1212
Practice Address - Country:US
Practice Address - Phone:603-643-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor