Provider Demographics
NPI:1730329483
Name:BURCH, ADAM STANLEY IV (DC, MPH)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:STANLEY
Last Name:BURCH
Suffix:IV
Gender:M
Credentials:DC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:16 MANNING ST STE 107
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2389
Mailing Address - Country:US
Mailing Address - Phone:603-434-1177
Mailing Address - Fax:603-434-9992
Practice Address - Street 1:16 MANNING ST STE 107
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2389
Practice Address - Country:US
Practice Address - Phone:603-434-1177
Practice Address - Fax:603-434-9992
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011830-1111N00000X
VT006.0066728111N00000X
NH900111N00000X
MA3402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor