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Individual

PATRICK JAMES CAROLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6 TSIENNETO RD, DERRY, NH 03038-1584
(603) 216-0400
Mailing address
6 TSIENNETO RD, DERRY, NH 03038-1584
(603) 216-0400

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S26800345
DRIVER'S LICENSE
MA
Enumeration date
08/05/2019
Last updated
11/06/2019
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