Provider Demographics
NPI:1205927779
Name:AVARD, JOHN B (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:AVARD
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 1:81 A ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-4715
Mailing Address - Country:US
Mailing Address - Phone:603-625-4019
Mailing Address - Fax:
Practice Address - Street 1:49 S RIVER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6726
Practice Address - Country:US
Practice Address - Phone:603-623-3030
Practice Address - Fax:603-623-2800
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH079-1091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH45081OtherCIGNA PROVIDER ID
NH0506386Y0NH01OtherBC/BS PROVIDER ID
NHNA1739OtherHPHC PROVIDER ID
NH45081OtherCIGNA PROVIDER ID
NHRE1992Medicare ID - Type Unspecified