Individual
JEFFREY D CHAMPAGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
555 AUBURN ST, MANCHESTER, NH 03103-4803
(603) 623-8863
(603) 623-3461
Mailing address
23 HEMLOCK CT, NEWFIELDS, NH 03856-8306
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2233
NH
Other
Enumeration date
10/12/2012
Last updated
10/12/2012
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