Organization
MAIN STREET CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRILYN N SULLIVAN (OWNER)
(603) 882-5742
Entity
Organization
Contact information
Practice address
382 MAIN ST, NASHUA, NH 03060-5046
(603) 882-5742
Mailing address
382 MAIN ST, NASHUA, NH 03060-5046
(603) 882-5742
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1120493
NH
111N00000X
Chiropractor
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023867
MEDICARE
NH
01
—
12289121
CAQH
NH
01
—
2612118
UNITED
NH
01
—
3557492
CIGNA
NH
01
—
5554684
AETNA
NH
01
—
615742
OPTUM
NH
01
—
AA228827
HARVARD
NH
Enumeration date
12/12/2013
Last updated
04/26/2023
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