Provider Demographics
NPI:1891943494
Name:WEISS CHIROPRACTIC OFFICE PLLC
Entity Type:Organization
Organization Name:WEISS CHIROPRACTIC OFFICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-224-1846
Mailing Address - Street 1:133 LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5611
Mailing Address - Country:US
Mailing Address - Phone:603-224-1846
Mailing Address - Fax:603-224-2028
Practice Address - Street 1:133 LOUDON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5611
Practice Address - Country:US
Practice Address - Phone:603-224-1846
Practice Address - Fax:603-224-2028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH550-1198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHU84414Medicare UPIN