Healthcare Provider Details

I. General information

NPI: 1255669040
Provider Name (Legal Business Name): DENISE MARIE PICKOWICZ D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2009
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 HOMESTEAD PL
ALTON NH
03809-4913
US

IV. Provider business mailing address

20 HOMESTEAD PL
ALTON NH
03809-4913
US

V. Phone/Fax

Practice location:
  • Phone: 603-855-2031
  • Fax: 603-855-2126
Mailing address:
  • Phone: 603-855-2031
  • Fax: 603-855-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number859-0210
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: