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Individual

DR. MICHAEL A. GLEASON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN DC

Contact information

Practice address
31 LOWELL RD, SUITE 5, WINDHAM, NH 03087-1811
(603) 890-3486
Mailing address
PO BOX 245, WINDHAM, NH 03087-0245
(603) 890-3486

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
074-0491
NH
111N00000X
Chiropractor
1796
MA
111N00000X
Chiropractor
X006324-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0502198YONH01
ANTHEM BLUE CROSS
NH
01
Y36336
BLUE CROSS MASSACHUSETTS
MA
Enumeration date
11/01/2006
Last updated
07/08/2007
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