Healthcare Provider Details
I. General information
NPI: 1972263176
Provider Name (Legal Business Name): ALTERNATIVE PAIN MANAGEMENT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2021
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
514 SOUTH ST STE 3
BOW NH
03304-3419
US
IV. Provider business mailing address
514 SOUTH ST STE 3
BOW NH
03304-3419
US
V. Phone/Fax
- Phone: 603-333-2384
- Fax:
- Phone: 603-333-2384
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 202D00000X |
| Taxonomy | Integrative Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LINDA
MARIE
SMITH
Title or Position: OWNER
Credential: MD
Phone: 603-333-2384