Provider Demographics
NPI:1851596159
Name:HERNER, JOHN A (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:HERNER
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 1:60 MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2720
Mailing Address - Country:US
Mailing Address - Phone:603-595-4600
Mailing Address - Fax:603-595-4609
Practice Address - Street 1:60 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2720
Practice Address - Country:US
Practice Address - Phone:603-595-4600
Practice Address - Fax:603-595-4609
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH817-0608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI669429OtherACN
RI11356004OtherAETNA
RI293688OtherBLUE CROSS OR RI
RI293688OtherBLUE CROSS OR RI
RI669429OtherACN