| NPI | 1710698667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXWELL HOGUE Owner 603-667-6765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2023-02-01 |