Individual
MRS. ALISON VANBROCKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
147 WASHINGTON ST, KEENE, NH 03431-3131
(603) 357-1395
(603) 357-1397
Mailing address
147 WASHINGTON ST, KEENE, NH 03431-3131
(603) 357-1395
(603) 357-1397
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0280
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0805957Y0NH01
ANTHEM PROVIDER #
NH
Enumeration date
05/17/2007
Last updated
07/08/2007
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