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General NPI Number Information
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NPI Number | 1609529239
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Entity Type | Individual
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Provider Name | BRONWIN SOUTHWICK CPHT
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Gender | Female
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 14 PETERBOROUGH ST
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City | JAFFREY
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State | NH
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Zip | 03452-5857
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Country | US
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Telephone | 603-532-6955
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Fax |
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Provider Business Mailing Address
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Address Line | 378 THORNDIKE POND RD
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City | JAFFREY
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State | NH
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Zip | 03452-5139
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Country | US
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Telephone | 603-562-4902
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Fax |
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | CPHT-124219
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License Number State | NH
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