Healthcare Provider Details

I. General information

NPI: 1043032931
Provider Name (Legal Business Name): NEW ENGLAND REGENERATIVE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 HUCKINS RD
FREEDOM NH
03836-4418
US

IV. Provider business mailing address

PO BOX 716
WEST OSSIPEE NH
03890-0716
US

V. Phone/Fax

Practice location:
  • Phone: 207-632-2657
  • Fax:
Mailing address:
  • Phone: 207-632-2657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT BROWN
Title or Position: PROPRIETOR
Credential: DO
Phone: 207-632-2657