Provider Demographics
NPI:1952790545
Name:NORTHSTAR HEALTH CENTER, INC
Entity type:Organization
Organization Name:NORTHSTAR HEALTH CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:LATHROP
Authorized Official - Suffix:IV
Authorized Official - Credentials:DC
Authorized Official - Phone:603-998-7282
Mailing Address - Street 1:3 WEST PINE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865
Mailing Address - Country:US
Mailing Address - Phone:603-998-7282
Mailing Address - Fax:
Practice Address - Street 1:3 W PINE ST APT 2
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2967
Practice Address - Country:US
Practice Address - Phone:603-998-7282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty