Organization · NPI-2

Aesthetic Medicine Of Nh

Family Medicine · Concord, NH

NPI number1710133087
StatusActive
Last updated in NPPESAug 18, 2008

Details

NPI
1710133087
Entity type
Organization (NPI-2)
Legal business name
Aesthetic Medicine Of Nh
Organization subpart
No
Enumeration date
Aug 18, 2008
Last updated
Aug 18, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine6630NHYes

Practice location

194 Pleasant St
Suite 12
Concord, NH 03301-2952

Phone 603-224-0808 · Fax 603-224-0853

Mailing address

194 Pleasant St
Suite 12
Concord, NH 03301-2952

Phone 603-224-0808 · Fax 603-224-0853

Authorized official

Nicholas Paul Van Loan
Business Owner
6032240808

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