Individual
DIANE G AVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
718 SMYTH RD, VA MEDICAL CENTER, MANCHESTER, NH 03104-7004
(603) 624-4366
Mailing address
718 SMYTH RD, VA MEDICAL CENTER, MANCHESTER, NH 03104-7004
(603) 624-4366
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
333
NH
Other
Enumeration date
06/26/2006
Last updated
04/13/2011
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