| NPI | 1588655567 |
|---|---|
| Other Name | ELLIOT FAMILY MEDICINE AT GLEN LAKE |
| Entity Type | Organization |
| Authorized Contact | RICHARD P. HERMAN Director Of Operations & Finance 603-663-4904 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2008-06-20 |