Healthcare Provider Details
I. General information
NPI: 1215182076
Provider Name (Legal Business Name): AFFILIATES IN PODIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2008
Last Update Date: 10/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 AIKEN AVENUE FRANKLIN REGIONAL HOSPITAL SPECIALTY CLINIC
FRANKLIN NH
03235
US
IV. Provider business mailing address
248 PLEASANT ST. SUITE 203
CONCORD NH
03301
US
V. Phone/Fax
- Phone: 603-934-2060
- Fax:
- Phone: 603-225-5281
- Fax: 603-228-7095
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
N
MCCANN
Title or Position: PRESIDENT
Credential: DPM
Phone: 603-225-5281