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Individual

MARILYNN ACKER EZELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
121 MAIN STREET, JAFFREY, NH 03452-6140
(603) 532-8835
(603) 532-7045
Mailing address
121 MAIN STREET, JAFFREY, NH 03452-6140
(603) 532-8835
(603) 532-7045

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
0372
NH
152W00000X
Optometrist
Primary
NH0372
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30351489
NH
Enumeration date
02/15/2006
Last updated
12/08/2014
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