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General NPI Number Information
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NPI Number | 1801123435
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Entity Type | Organization
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Legal Business Name | TOTAL PAIN CARE AND WELLNESS P.A.
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 95 STILES RD SUITE 107
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City | SALEM
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State | NH
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Zip | 03079-4805
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Country | US
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Telephone | 603-952-4804
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Fax | 603-952-4806
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Provider Business Mailing Address
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Address Line | 95 STILES RD SUITE 107
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City | SALEM
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State | NH
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Zip | 03079-4805
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Country | US
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Telephone | 603-952-4804
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Fax | 603-952-4806
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Authorized Official
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Title or Position | OWNER
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Name | KRISTEN HARDING
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Credential | ARNP
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Telephone | 603-952-4804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 05735023
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License Number State | NH
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