Healthcare Provider Details

I. General information

NPI: 1710279690
Provider Name (Legal Business Name): OURLIFE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 LAFAYETTE RD SUITE 102
PORTSMOUTH NH
03801-5407
US

IV. Provider business mailing address

485 HIGH ST
HAMPTON NH
03842-2349
US

V. Phone/Fax

Practice location:
  • Phone: 603-319-1701
  • Fax: 603-319-1713
Mailing address:
  • Phone: 603-319-1701
  • Fax: 603-319-1713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberH573
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number242
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number287
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberH584
License Number StateNH

VIII. Authorized Official

Name: DANIEL FANEUF
Title or Position: OWNER/V PRESIDENT
Credential: HIS
Phone: 603-319-1701