Healthcare Provider Details

I. General information

NPI: 1558942250
Provider Name (Legal Business Name): SOUTHERN NEW HAMPSHIRE HEALTH & BALANCE CENTER, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

547 AMHERST ST STE 208
NASHUA NH
03063-4000
US

IV. Provider business mailing address

547 AMHERST ST STE 204
NASHUA NH
03063-4000
US

V. Phone/Fax

Practice location:
  • Phone: 603-889-7434
  • Fax: 603-889-9531
Mailing address:
  • Phone: 603-889-7434
  • Fax: 603-889-9531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA L WOODS
Title or Position: OWNER
Credential:
Phone: 603-889-7434