Healthcare Provider Details

I. General information

NPI: 1225464241
Provider Name (Legal Business Name): BRUCE E. HADDEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 PORTSMOUTH AVE
STRATHAM NH
03885-2467
US

IV. Provider business mailing address

17 RIVERVIEW ST
BEVERLY MA
01915-4135
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-6400
  • Fax:
Mailing address:
  • Phone: 978-998-5642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH1699
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH1699
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number930
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: