Provider Demographics
NPI:1992965107
Name:AMHERST FAMILY CHIROPRACTIC WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:AMHERST FAMILY CHIROPRACTIC WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GASCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:603-673-0010
Mailing Address - Street 1:89 ROUTE 101A
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2290
Mailing Address - Country:US
Mailing Address - Phone:603-673-0010
Mailing Address - Fax:603-673-2366
Practice Address - Street 1:89 ROUTE 101A
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2290
Practice Address - Country:US
Practice Address - Phone:603-673-0010
Practice Address - Fax:603-673-2366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH761-0406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty