Healthcare Provider Details

I. General information

NPI: 1801097647
Provider Name (Legal Business Name): JOSEPH P LAROCHELLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N STATE ST
CONCORD NH
03301-4038
US

IV. Provider business mailing address

PO BOX 32
ANDOVER NH
03216-0032
US

V. Phone/Fax

Practice location:
  • Phone: 603-225-2512
  • Fax: 603-225-3249
Mailing address:
  • Phone: 603-735-6060
  • Fax: 603-735-6070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0362
License Number StateNH

VIII. Authorized Official

Name: JOSEPH P. LAROCHELLE
Title or Position: O.D./OWNER
Credential: O.D.
Phone: 603-225-2512