Organization
RIVERSIDE WELLNESS CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUE ANN SIDELL DC (MANAGER)
(603) 752-7727
Entity
Organization
Contact information
Practice address
630 MAIN ST, GORHAM, NH 03581-4900
(603) 752-7727
(603) 752-2820
Mailing address
630 MAIN ST, GORHAM, NH 03581-4900
(603) 752-7727
(603) 752-2820
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
282-0397
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30257098
—
NH
Enumeration date
03/11/2009
Last updated
03/11/2009
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