Healthcare Provider Details
I. General information
NPI: 1689225773
Provider Name (Legal Business Name): ALBRECHT INTEGRATIVE OSTEOPATHY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
707 CHESTNUT ST
MANCHESTER NH
03104-3010
US
IV. Provider business mailing address
25 CATHEDRAL CIR
NASHUA NH
03063-2716
US
V. Phone/Fax
- Phone: 414-870-8550
- Fax:
- Phone: 414-870-8550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JASON
MICHAEL
ALBRECHT
Title or Position: OWNER
Credential: DO
Phone: 414-870-8550