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General NPI Number Information
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NPI Number | 1952790545
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Entity Type | Organization
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Legal Business Name | NORTHSTAR HEALTH CENTER, INC
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 3 W PINE ST APT 2
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City | PLAISTOW
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State | NH
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Zip | 03865-2967
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Country | US
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Telephone | 603-998-7282
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Fax |
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Provider Business Mailing Address
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Address Line | 3 WEST PINE ST APT 2
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City | PLAISTOW
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State | NH
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Zip | 03865
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Country | US
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Telephone | 603-998-7282
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN MARCUS LATHROP IV
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Credential | DC
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Telephone | 603-998-7282
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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 | 946
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License Number State | NH
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