Facts
- Status
- A
- Credential
- Rph
- Type
- Individual
- Enumeration date
- 2011-08-30
- Last updated
- 2011-08-30
Specialties
Licenses
- License MA
- 19652
- License NH
- R2191
Location
- Practice location
- 12 MAIN ST
- City
- EPPING NH
- Postal code
- 030422425
- Phone
- 603-679-5839
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.