| 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 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2023-07-25 |