Healthcare Provider Details

I. General information

NPI: 1508772054
Provider Name (Legal Business Name): KING RECOVERY MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 BREK DR
MERRIMACK NH
03054-4506
US

IV. Provider business mailing address

923 ELM ST UNIT 160
MANCHESTER NH
03101-2003
US

V. Phone/Fax

Practice location:
  • Phone: 978-846-2975
  • Fax: 978-846-2975
Mailing address:
  • Phone: 978-846-2975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RENEE KING
Title or Position: OWNER
Credential: APRN
Phone: 978-846-2975