MEDICARE: HS1 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1154893832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HS1 LLC

Provider Business Mailing Address
First Line	:	545 HOOKSETT RD UNIT 20
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03104-2654
Country	:	US
Telephone Number	:	603-413-8747
Fax Number	:	603-332-0600

Provider Business Practice Location Address
First Line	:	545 HOOKSETT RD UNIT 20
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03104-2654
Country	:	US
Telephone Number	:	603-413-8747
Fax Number	:	603-332-0600

Authorized Official
Title or Position	:	OWNER
Name	:	JEFF KLAUBERT
Credential	:
Telephone Number	:	603-413-8747

Provider Enumeration Date	:	12/19/2018
Last Update Date	:	05/20/2019

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