Provider Demographics
NPI:1679642763
Name:JAGGN LLC
Entity Type:Organization
Organization Name:JAGGN LLC
Other - Org Name:AARROW STRAIGHT CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DC
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:GOSSELIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-882-7769
Mailing Address - Street 1:2 OLD DERRY RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-3309
Mailing Address - Country:US
Mailing Address - Phone:603-882-7769
Mailing Address - Fax:603-598-8206
Practice Address - Street 1:2 OLD DERRY ROAD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051
Practice Address - Country:US
Practice Address - Phone:603-882-7769
Practice Address - Fax:603-598-8206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0791091A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3104Medicare PIN