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General NPI Number Information
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NPI Number | 1578973509
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Entity Type | Organization
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Legal Business Name | EDELSTEIN FAMILY AND SPORTS CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 28 OLD RD
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City | PLAISTOW
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State | NH
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Zip | 03865-2928
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Country | US
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Telephone | 603-382-8834
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Fax | 603-382-1536
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Provider Business Mailing Address
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Address Line | PO BOX 1195
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City | PLAISTOW
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State | NH
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Zip | 03865-1195
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Country | US
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Telephone | 603-382-8834
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Fax | 603-382-1536
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW IAN EDELSTEIN
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Credential | D.C.
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Telephone | 603-382-8834
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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 | 567-0899
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License Number State | NH
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