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General NPI Number Information
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NPI Number | 1407340672
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Entity Type | Organization
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Legal Business Name | BAZZANI CHIROPRACTIC MANCHESTER, LLC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 1361 ELM ST STE 104
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City | MANCHESTER
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State | NH
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Zip | 03101-1315
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Country | US
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Telephone | 603-206-4346
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Fax |
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Provider Business Mailing Address
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Address Line | 1361 ELM ST STE 104
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City | MANCHESTER
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State | NH
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Zip | 03101-1315
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Country | US
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Telephone | 603-206-4346
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LISA LANZARA-BAZZANI
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Credential | DC
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Telephone | 603-557-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 225-1095
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License Number State | NH
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