Healthcare Provider Details

I. General information

NPI: 1518056290
Provider Name (Legal Business Name): JOHN D DAVIES LPP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 POST OFFICE SQ
PLYMOUTH NH
03264-1533
US

IV. Provider business mailing address

711 MT ISRAEL RD
CTR SANDWICH NH
03227-3712
US

V. Phone/Fax

Practice location:
  • Phone: 603-591-2066
  • Fax: 603-284-6166
Mailing address:
  • Phone: 603-591-2066
  • Fax: 603-284-6166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number62
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: