Provider Demographics
NPI:1548918113
Name:GONSALVES, VICTORIA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LYNN
Last Name:GONSALVES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 CONGRESS ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3334
Mailing Address - Country:US
Mailing Address - Phone:603-809-8243
Mailing Address - Fax:
Practice Address - Street 1:660 MAST RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-1218
Practice Address - Country:US
Practice Address - Phone:603-809-8243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1117111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor