MEDICARE: NEW LONDON CHIROPRACTIC CENTER, PLLC

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	842-0509	NH

General Provider Information

NPI Number	:	1902133242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LONDON CHIROPRACTIC CENTER, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 1216
Second Line	:	71 PLEASANT STREET
City	:	NEW LONDON
State	:	NH
Zip	:	03257-1216
Country	:	US
Telephone Number	:	603-526-6522
Fax Number	:	603-526-2115

Provider Business Practice Location Address
First Line	:	71 PLEASANT STREET
Second Line	:
City	:	NEW LONDON
State	:	NH
Zip	:	03257-1216
Country	:	US
Telephone Number	:	603-526-6522
Fax Number	:	603-526-2115

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	OLIVIA POWERS
Credential	:	D.C.
Telephone Number	:	603-526-6522

Provider Enumeration Date	:	11/06/2009
Last Update Date	:	11/06/2009

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