Healthcare Provider Details

I. General information

NPI: 1891943494
Provider Name (Legal Business Name): WEISS CHIROPRACTIC OFFICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 LOUDON RD
CONCORD NH
03301-5611
US

IV. Provider business mailing address

133 LOUDON RD
CONCORD NH
03301-5611
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-1846
  • Fax: 603-224-2028
Mailing address:
  • Phone: 603-224-1846
  • Fax: 603-224-2028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number550-1198
License Number StateNH

VIII. Authorized Official

Name: DR. KEITH ANDREW WEISS
Title or Position: MEMBER
Credential: D.C.
Phone: 603-224-1846