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General NPI Number Information
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NPI Number | 1538987078
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Entity Type | Organization
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Legal Business Name | EAGLE SUNRISE, LLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 74 HEDDING RD
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City | EPPING
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State | NH
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Zip | 03042-2526
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Country | US
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Telephone | 413-265-5498
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Fax |
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Provider Business Mailing Address
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Address Line | 20 TRI CITY PLAZA UNIT 0001 #1011
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City | SOMERSWORTH
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State | NH
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Zip | 03878
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Country | US
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Telephone | 413-265-5498
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARISSA DUNN
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Credential |
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Telephone | 413-265-5498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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