| NPI | 1669685368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA TROTTIER Billing Specialist 603-644-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NH NH0550) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH NH0769) |
| 152W00000X Optometrist (Licence: NH NH0616) | |
| 152W00000X Optometrist (Licence: NH 0550) | |
| 152W00000X Optometrist (Licence: NH 0616) | |
| 152W00000X Optometrist (Licence: NH 0769) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-09-24 |