Provider Demographics
NPI:1659364123
Name:BARD, JANELLE L (DC)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:L
Last Name:BARD
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:PO BOX 688
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NH
Mailing Address - Zip Code:03251-0688
Mailing Address - Country:US
Mailing Address - Phone:603-745-2777
Mailing Address - Fax:603-745-4327
Practice Address - Street 1:6 SOUTH MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NH
Practice Address - Zip Code:03251
Practice Address - Country:US
Practice Address - Phone:603-745-2777
Practice Address - Fax:603-745-4327
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2008-10-01
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
NH5850200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
05Y002453NH01OtherANTHEM
509270OtherCIGNA
NHRE5577Medicare PIN
U78697Medicare UPIN