Individual
ALISA GAIL CANILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-2651
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-2651
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
596
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012026
—
VT
Enumeration date
07/30/2006
Last updated
10/17/2011
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