Provider Demographics
NPI:1790797140
Name:ARSENAULT, MARK B (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:ARSENAULT
Suffix:
Gender:M
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 199
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-0199
Mailing Address - Country:US
Mailing Address - Phone:603-964-1460
Mailing Address - Fax:603-964-2188
Practice Address - Street 1:29 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2436
Practice Address - Country:US
Practice Address - Phone:603-964-1460
Practice Address - Fax:603-964-2188
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH200-0495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0505700Y0NH02OtherBLUE CROSS BLUE SHIELD
NH063736Medicare UPIN
NHRE4306Medicare ID - Type Unspecified