Provider Demographics
NPI:1831527118
Name:WHITE MOUNTAIN CHIROPRACTIC AND REHABILITATION PLLC
Entity type:Organization
Organization Name:WHITE MOUNTAIN CHIROPRACTIC AND REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER-SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:LAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-899-5153
Mailing Address - Street 1:140 EDMOND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-3562
Mailing Address - Country:US
Mailing Address - Phone:603-978-5041
Mailing Address - Fax:
Practice Address - Street 1:1102 ROUTE 119
Practice Address - Street 2:
Practice Address - City:RINDGE
Practice Address - State:NH
Practice Address - Zip Code:03461
Practice Address - Country:US
Practice Address - Phone:603-978-5041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty