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General NPI Number Information
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NPI Number | 1972972511
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Entity Type | Organization
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Legal Business Name | SANTE CENTER FOR NATURAL HEALING, LLC
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Dates
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Enumeration Date | 09/24/2015
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 540 LAFAYETTE RD SUITE 2
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City | HAMPTON
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State | NH
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Zip | 03842-3344
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Country | US
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Telephone | 603-929-0084
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Fax | 603-929-1184
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Provider Business Mailing Address
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Address Line | 540 LAFAYETTE RD SUITE 2
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City | HAMPTON
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State | NH
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Zip | 03842-3344
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Country | US
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Telephone | 603-929-0084
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Fax | 603-929-1184
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK L SU
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Credential | MD
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Telephone | 603-929-0084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 15600
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License Number State | NH
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