| NPI | 1275535999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH GORDON CEO 603-752-3669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 213E00000X Podiatrist | |
| 363AM0700X Physician Assistant, Medical | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2020-09-17 |