Provider Demographics
NPI:1619078185
Name:KNEELAND, MICHAEL E III (DC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:KNEELAND
Suffix:III
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 1:58 RANGE RD STE R-03
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-2026
Mailing Address - Country:US
Mailing Address - Phone:603-898-0030
Mailing Address - Fax:603-894-6343
Practice Address - Street 1:58 RANGE RD STE R-03
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-2026
Practice Address - Country:US
Practice Address - Phone:603-898-0030
Practice Address - Fax:603-894-6343
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2231095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30251661Medicaid
NH30251661Medicaid
NHKNRE3942Medicare ID - Type Unspecified