Provider Demographics
NPI:1932344694
Name:HANOVER CHIROPRACTIC HEALTH CARE LLC
Entity type:Organization
Organization Name:HANOVER CHIROPRACTIC HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS HENEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-331-8939
Mailing Address - Street 1:24 ROCKLAND ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2226
Mailing Address - Country:US
Mailing Address - Phone:781-826-7397
Mailing Address - Fax:781-826-7469
Practice Address - Street 1:24 ROCKLAND ST
Practice Address - Street 2:UNIT 1
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2226
Practice Address - Country:US
Practice Address - Phone:781-826-7397
Practice Address - Fax:781-826-7469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty