Healthcare Provider Details

I. General information

NPI: 1740510817
Provider Name (Legal Business Name): NORMAN PAUL FOURNIER BC-HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 01/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 MAST RD
MANCHESTER NH
03102-1539
US

IV. Provider business mailing address

757 MAST RD
MANCHESTER NH
03102-1539
US

V. Phone/Fax

Practice location:
  • Phone: 603-669-3318
  • Fax: 603-669-5573
Mailing address:
  • Phone: 603-669-3318
  • Fax: 603-669-5573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number208
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: