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1780138495
SCOTT S MIRICK
LEBANON, NH
NPI
1780138495
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Former Name
JOHN SCOTT SHADDY
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NH 1179)
Enumeration Date
2016-08-10
Last Update Date
2019-09-18
Business Address
SCOTT S MIRICK PA
1 MEDICAL CENTER DR
LEBANON, NH 03756-0001
Phone number: 603-650-8537
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Mailing Address
SCOTT S MIRICK PA
1 MEDICAL CENTER DR
LEBANON, NH 03756-0001
Phone number:
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