Provider Demographics
NPI:1144232612
Name:MCLAIN CHIROPRACTIC CENTER, PLLC
Entity type:Organization
Organization Name:MCLAIN CHIROPRACTIC CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-448-2515
Mailing Address - Street 1:27 BANK ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1702
Mailing Address - Country:US
Mailing Address - Phone:603-448-2515
Mailing Address - Fax:603-448-2622
Practice Address - Street 1:27 BANK ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1702
Practice Address - Country:US
Practice Address - Phone:603-448-2515
Practice Address - Fax:603-448-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH140-1153-0584A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0508447Y0NH02OtherBLUE CROSS BLUE SHIELD
VT8447OtherVT BLUE CROSS,BLUE SHIELD
NH5071355OtherCIGNA
NH5224221OtherAETNA
NH5071355OtherCIGNA
NH5071355OtherCIGNA
NHRE8081Medicare ID - Type Unspecified