Individual
DAVEN LOWELL SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1802 ELM ST, SUITE3, MANCHESTER, NH 03104-2948
(603) 657-8460
Mailing address
1802 ELM ST, SUITE3, MANCHESTER, NH 03104-2948
(603) 657-8460
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
830-0109
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02-0474867
FED TAX ID
UT
01
—
2103513
FIRST HEALTH
UT
01
—
72478
PEHP
UT
01
—
870395551SP4
EDUCATORS MUTUAL INS.
UT
01
—
RE333101
MEDICARE
NH
Enumeration date
04/27/2006
Last updated
07/24/2014
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