Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 424A | NH |
NPI | 1013042092 |
---|---|
Provider Name | David Albert Ridge |
First Address | Keene, NH 03431-3410 |
Second Address | Keene, NH 03431-3410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0508598YONHO | ANTHEM (01) | NH |
30253276 | (05) | NH |