Healthcare Provider Details

I. General information

NPI: 1528088333
Provider Name (Legal Business Name): BREAKFAST HILL CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1247 WASHINGTON RD
RYE NH
03870-2346
US

IV. Provider business mailing address

1247 WASHINGTON RD
RYE NH
03870-2346
US

V. Phone/Fax

Practice location:
  • Phone: 603-964-1500
  • Fax: 603-964-1591
Mailing address:
  • Phone: 603-964-1500
  • Fax: 603-964-1591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number254-0496
License Number StateNH

VIII. Authorized Official

Name: DR. JEFFREY W. ROGERS
Title or Position: OWNER
Credential: D.C.
Phone: 603-964-1500