Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | NH2510696 | NH |
NPI | 1487775227 |
---|---|
Provider Name | Dr. John Rene Pinault |
First Address | Goffstown, NH 03045-1767 |
Second Address | Goffstown, NH 03045-1767 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30010868 | (05) | NH |