Provider Demographics
NPI:1548352255
Name:WELLINGTON CHIROPRACTIC PA
Entity type:Organization
Organization Name:WELLINGTON CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BARONE
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:603-668-0511
Mailing Address - Street 1:610 OLD WELLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4112
Mailing Address - Country:US
Mailing Address - Phone:603-668-0511
Mailing Address - Fax:603-641-5368
Practice Address - Street 1:610 OLD WELLINGTON RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4112
Practice Address - Country:US
Practice Address - Phone:603-668-0511
Practice Address - Fax:603-641-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH514A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0505943YONHO1Medicare UPIN
NH8684Medicare ID - Type Unspecified