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General NPI Number Information
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NPI Number | 1902317670
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Entity Type | Individual
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Provider Name | ALEXANDRIA SARAH RAIFSNIDER
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Gender | Female
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 10/20/2017
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Provider Practice Location Address
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Address Line | 19 HIGHLAND AVE
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City | PLYMOUTH
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State | NH
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Zip | 03264-1585
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Country | US
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Telephone | 603-393-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 60 COLLEGE RD
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City | WOLFEBORO
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State | NH
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Zip | 03894-4609
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Country | US
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Telephone | 603-393-1130
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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 | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number | NA
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License Number State | NH
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