Healthcare Provider Details
I. General information
NPI: 1225023864
Provider Name (Legal Business Name): ERIK N BAKKE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 09/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
339 HIGH ST
SOMERSWORTH NH
03878-1415
US
IV. Provider business mailing address
173 TOLEND RD
DOVER NH
03820-5510
US
V. Phone/Fax
- Phone: 603-692-2376
- Fax: 603-692-6553
- Phone: 603-343-1474
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 2381086B |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: