Healthcare Provider Details

I. General information

NPI: 1588855258
Provider Name (Legal Business Name): THE ALPINE CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 PROFILE ROAD
FRANCONIA NH
03580
US

IV. Provider business mailing address

1095 PROFILE ROAD
FRANCONIA NH
03580
US

V. Phone/Fax

Practice location:
  • Phone: 603-823-8600
  • Fax: 603-823-8688
Mailing address:
  • Phone: 603-823-8600
  • Fax: 603-823-8688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number12418
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW L CHEN
Title or Position: PARTNER/OWNER
Credential: M.D.
Phone: 603-823-8600