Individual
JACQUELINE A RHEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
248 PLEASANT ST, STE 1600, CONCORD, NH 03301-2588
(603) 224-2020
(603) 228-0248
Mailing address
248 PLEASANT ST, STE 1600, CONCORD, NH 03301-2588
(603) 224-2020
(603) 228-0248
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0646
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0900169YONH01
ANTHEM
NH
05
—
30010905
—
NH
01
—
312992
CIGNA
NH
01
—
410038181
MEDICARE RR
—
Enumeration date
08/02/2005
Last updated
04/21/2020
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