Provider Demographics
NPI:1790845477
Name:PARENT, J DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:DANIEL
Last Name:PARENT
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 1:14 SETTLERS RDG
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-2387
Mailing Address - Country:US
Mailing Address - Phone:603-890-6257
Mailing Address - Fax:603-965-1057
Practice Address - Street 1:184 MAMMOTH RD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053
Practice Address - Country:US
Practice Address - Phone:603-434-8300
Practice Address - Fax:603-965-1057
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH 1961094111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE 3824Medicare ID - Type UnspecifiedCHIROPRACTIC