Provider Demographics
NPI:1790167427
Name:COMMUNITY CHIROPRACTIC
Entity Type:Organization
Organization Name:COMMUNITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:SANZONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-229-0021
Mailing Address - Street 1:85 MANCHESTER ST.
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5140
Mailing Address - Country:US
Mailing Address - Phone:603-229-0021
Mailing Address - Fax:
Practice Address - Street 1:85 MANCHESTER ST
Practice Address - Street 2:85 MANCHESTER ST
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5140
Practice Address - Country:US
Practice Address - Phone:603-229-0021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH155 1093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE2932Medicare UPIN