Provider Demographics
NPI:1730107665
Name:UPPER VALLEY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:UPPER VALLEY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCLELLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-298-7400
Mailing Address - Street 1:107 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-1618
Mailing Address - Country:US
Mailing Address - Phone:602-298-7400
Mailing Address - Fax:603-298-7421
Practice Address - Street 1:107 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-1618
Practice Address - Country:US
Practice Address - Phone:602-298-7400
Practice Address - Fax:603-298-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH713-0204111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty