Healthcare Provider Details

I. General information

NPI: 1003820952
Provider Name (Legal Business Name): MANCHESTER SPINE AND REHAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 12/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 SOUTH ST UNIT 2
CONCORD NH
03301-2829
US

IV. Provider business mailing address

101 BRICK KILN RD BLDG 1, UNIT 5
CHELMSFORD MA
01824-3282
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-0551
  • Fax:
Mailing address:
  • Phone: 978-250-0230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: FREDERICK GIAMPA
Title or Position: CO-OWNER
Credential: DC
Phone: 978-250-0230