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General NPI Number Information
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NPI Number | 1821046061
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Entity Type | Organization
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Legal Business Name | MERRIMACK VALLEY ORTHOPAEDIC SURGERY
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 4 ELLIOT WAY SUITE 100
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City | MANCHESTER
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State | NH
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Zip | 03103-3547
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Country | US
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Telephone | 603-625-1655
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Fax | 603-626-4686
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Provider Business Mailing Address
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Address Line | 4 ELLIOT WAY SUITE 100
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City | MANCHESTER
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State | NH
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Zip | 03103-3547
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Country | US
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Telephone | 603-625-1655
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Fax | 603-626-4686
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DOROTHY OLIVIER
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Credential |
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Telephone | 603-668-4253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 8097
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License Number State | NH
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