Riverside Wellness Center, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

282-0397 Issued in NH

Legal business name

RIVERSIDE WELLNESS CENTER, PLLC

Practice address

630 Main St
Gorham, NH 03581-4900

Phone

(603) 752-7727

Fax

(603) 752-2820

NPI assigned

Mar 11, 2009

Last updated

Mar 11, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sue Ann Sidell, DC

Title

Manager

Phone

(603) 752-7727

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1629219241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 MAIN ST",
            "city": "GORHAM",
            "state": "NH",
            "postal_code": "035814900",
            "telephone_number": "603-752-7727",
            "fax_number": "603-752-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MAIN ST",
            "city": "GORHAM",
            "state": "NH",
            "postal_code": "035814900",
            "telephone_number": "603-752-7727",
            "fax_number": "603-752-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "SIDELL",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "603-752-7727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NH",
            "license": "282-0397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30257098",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorraine S Mushacke, LICSW
• Amy Beth Page, APRN
• Paul C Schoenbeck, DMD., PA (North Country Dental)
• Ahmad Bin Rashid, D.P.M.
• Rite Aid of New Hampshire Inc (Rite Aid Pharmacy 04157)
• Riverside Wellness PLLC
• Lorie L Saunders, PHARM.D, RPH
• Paul C Schoenbeck, DMD
• Charles M Sidell, D.C.
• Sue Ann Sidell DC (Riverside Wellness Center)

• Chiropractor in Gorham, NH
• Providers in Gorham, NH by specialty
• Chiropractor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.