| NPI | 1619057080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA L GILBERT Practice Administrator 603-773-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |