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General NPI Number Information
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NPI Number | 1568762672
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Entity Type | Individual
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Provider Name | AMY M LEBLANC PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 85 SPRING ST STE 2A1
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City | LACONIA
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State | NH
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Zip | 03246-3113
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Country | US
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Telephone | 603-524-1600
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Fax | 603-227-7556
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Provider Business Mailing Address
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Address Line | 250 PLEASANT ST
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City | CONCORD
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State | NH
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Zip | 03301-2598
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Country | US
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Telephone | 603-227-7000
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Fax | 603-216-3800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0798
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License Number State | NH
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