Healthcare Provider Details

I. General information

NPI: 1285918441
Provider Name (Legal Business Name): SOUTHERN NEW HAMPSHIRE VETERINARY REFERRAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 ABBY RD
MANCHESTER NH
03103-3363
US

IV. Provider business mailing address

336 ABBY RD
MANCHESTER NH
03103-3363
US

V. Phone/Fax

Practice location:
  • Phone: 603-782-8181
  • Fax: 603-782-8167
Mailing address:
  • Phone: 603-782-8181
  • Fax: 603-782-8167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number1354
License Number StateNH

VIII. Authorized Official

Name: JOSHUA ALEXANDER JASPER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 603-782-8181