Individual
NICOLE WALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 HIGH ST, PLYMOUTH, NH 03264-1595
(860) 488-0641
Mailing address
16 HIGHLAND ST, PLYMOUTH, NH 03264-1143
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/12/2021
Last updated
08/12/2021
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