Provider Demographics
NPI:1780723825
Name:CAMMACK, WALTER F IV (DC)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:F
Last Name:CAMMACK
Suffix:IV
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 1:925 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2047
Mailing Address - Country:US
Mailing Address - Phone:603-934-3139
Mailing Address - Fax:603-934-3139
Practice Address - Street 1:925 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2047
Practice Address - Country:US
Practice Address - Phone:603-934-3139
Practice Address - Fax:603-934-3139
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH268-0996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor