Provider Demographics
NPI:1659635704
Name:DIMOS, ALISSA SUSAN (DC, CACCP)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:SUSAN
Last Name:DIMOS
Suffix:
Gender:F
Credentials:DC, CACCP
Other - Prefix:DR
Other - First Name:ALISSA
Other - Middle Name:SUSAN
Other - Last Name:DEMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, CACCP
Mailing Address - Street 1:116 S RIVER RD UNIT F
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6734
Mailing Address - Country:US
Mailing Address - Phone:603-232-1890
Mailing Address - Fax:603-605-1025
Practice Address - Street 1:116 S RIVER RD UNIT F
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6734
Practice Address - Country:US
Practice Address - Phone:603-232-1890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor