Healthcare Provider Details

I. General information

NPI: 1104769314
Provider Name (Legal Business Name): MAX MCCLASKIE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 S MAIN ST
WOLFEBORO NH
03894-4412
US

IV. Provider business mailing address

319 VITTUM HILL RD
SANDWICH NH
03227-3468
US

V. Phone/Fax

Practice location:
  • Phone: 603-569-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number36236
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: