Organization
PEMBROKE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBBORAH J KAITZ (OFFICE MANAGER)
(603) 485-7788
Entity
Organization
Contact information
Practice address
48 GLASS ST, PEMBROKE, NH 03275-1506
(603) 485-7788
Mailing address
48 GLASS ST, PEMBROKE, NH 03275-1506
(603) 485-7788
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30010430
—
NH
01
—
37162
CIGNA
NH
Enumeration date
05/15/2007
Last updated
06/18/2008
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