Provider Demographics
NPI:1952374134
Name:PATERSON, BRIAN J (ND, LAC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:PATERSON
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 PICKEREL POND RD
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-1510
Mailing Address - Country:US
Mailing Address - Phone:603-524-9261
Mailing Address - Fax:603-279-8870
Practice Address - Street 1:203 PICKEREL POND RD
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-1510
Practice Address - Country:US
Practice Address - Phone:603-524-9261
Practice Address - Fax:603-279-8870
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHN005171100000X
NH31175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH11Y003821NH01OtherANTHEM