Provider Demographics
NPI:1548855547
Name:DEGANGE CHIROPRACTIC
Entity type:Organization
Organization Name:DEGANGE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTANA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:DEGANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-224-5551
Mailing Address - Street 1:14 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3772
Mailing Address - Country:US
Mailing Address - Phone:603-568-4391
Mailing Address - Fax:
Practice Address - Street 1:14 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3772
Practice Address - Country:US
Practice Address - Phone:603-224-5551
Practice Address - Fax:603-224-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty