Provider Demographics
NPI:1245336080
Name:MOSENTHAL, TODD MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:MICHAEL
Last Name:MOSENTHAL
Suffix:
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 1:101 BOULDER POINT DR STE 1
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-3170
Mailing Address - Country:US
Mailing Address - Phone:603-536-5885
Mailing Address - Fax:603-536-4001
Practice Address - Street 1:101 BOULDER POINT DR STE 1
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-3170
Practice Address - Country:US
Practice Address - Phone:603-536-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2024-09-18
Deactivation Date:2020-05-05
Deactivation Code:
Reactivation Date:2020-05-20
Provider Licenses
StateLicense IDTaxonomies
NH189-1085A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNA1791OtherHARVARD PILGRIM
NH14230OtherCIGNA
VT0RE1315Medicaid
NH0503234Y0NH01OtherANTHEM
NH30011444Medicaid
NHT39683Medicare UPIN
NH30011444Medicaid