NPI | 1114524824 |
---|---|
Doing Business As | FULL LIFE PAIN AND DEPRESSION CENTER |
Entity Type | Organization |
Authorized Contact | MELYNDA WALLACE Owner 603-309-3902 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
Enumeration Date | 2020-10-06 |
Last Update Date | 2023-07-25 |