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General NPI Number Information
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NPI Number | 1104007426
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Entity Type | Organization
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Legal Business Name | WOODBURY FAMILY PRACTICE
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 7 MILL RD UNIT C
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City | DURHAM
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State | NH
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Zip | 03824-3047
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Country | US
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Telephone | 603-430-0060
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Fax | 603-570-2036
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Provider Business Mailing Address
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Address Line | 7 MILL ROAD PLZ # C
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City | DURHAM
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State | NH
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Zip | 03824-3047
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Country | US
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Telephone | 603-430-0060
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Fax | 603-570-2036
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Authorized Official
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Title or Position | DIRECTOR
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Name | KENNETH WASHINGTON
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Credential |
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Telephone | 603-430-2935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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