Provider Demographics
NPI:1194064006
Name:HELLIESEN, ANGELA LOUISE (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:LOUISE
Last Name:HELLIESEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:LOUISE
Other - Last Name:RUMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3 NORTHERN BLVD STE A4
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2329
Mailing Address - Country:US
Mailing Address - Phone:035-548-5096
Mailing Address - Fax:
Practice Address - Street 1:3 NORTHERN BLVD STE A4
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2329
Practice Address - Country:US
Practice Address - Phone:603-554-8509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-13
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH917111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor