Healthcare Provider Details

I. General information

NPI: 1164661138
Provider Name (Legal Business Name): NASHUA NATURAL MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 NASHUA ST
MILFORD NH
03055-4911
US

IV. Provider business mailing address

354 NASHUA ST
MILFORD NH
03055-4911
US

V. Phone/Fax

Practice location:
  • Phone: 603-672-3600
  • Fax:
Mailing address:
  • Phone: 603-672-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number16
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number8
License Number StateNH

VIII. Authorized Official

Name: MR. SEAN PATRICK DOHERTY
Title or Position: OWNER/MEMBER
Credential: L.AC, DNBAO
Phone: 603-672-3600