Organization
INTEGRATIVE HEALTH & WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYLOU CASSIDY APRN (OWNER/MANAGER)
(603) 831-1191
Entity
Organization
Contact information
Practice address
1283 MAIN ST UNIT 6C, DUBLIN, NH 03444-8242
(603) 831-1191
(833) 924-0345
Mailing address
48 NORTH RD, HANCOCK, NH 03449-5508
(603) 831-1911
(833) 924-0345
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114536877
—
NH
Enumeration date
07/29/2020
Last updated
11/02/2020
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