Healthcare Provider Details
I. General information
NPI: 1801933791
Provider Name (Legal Business Name): JOSEPH P LAROCHELLE OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/31/2007
Last Update Date: 12/15/2017
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
8 N STATE ST
CONCORD NH
03301-4038
US
V. Phone/Fax
- Phone: 603-225-2512
- Fax: 603-225-3249
- Phone: 603-225-2512
- Fax: 603-225-3249
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 0362 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: