Individual
THOMAS OSBORN WANSLEBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 653-9500
(603) 650-0915
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 653-9500
(603) 650-0915
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0AP0936
—
VT
05
—
40005138
—
NH
Enumeration date
06/15/2006
Last updated
11/03/2011
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