Healthcare Provider Details

I. General information

NPI: 1679239255
Provider Name (Legal Business Name): JAMES MILLS III HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 PLAINFIELD RD
WEST LEBANON NH
03784-2017
US

IV. Provider business mailing address

PO BOX 629
GRANTHAM NH
03753-0629
US

V. Phone/Fax

Practice location:
  • Phone: 603-790-8157
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1118
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: