| NPI | 1811264559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L WEYMOUTH Owner 603-818-8914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NH 12895) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 219696) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2014-04-10 |