Organization
CENTER STATE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL HOWARD FNP (AUTHORIZED OFFICIAL)
(603) 556-7101
Entity
Organization
Contact information
Practice address
102 PLEASANT ST, CONCORD, NH 03301-3863
(603) 556-7101
(949) 404-6458
Mailing address
102 PLEASANT ST, CONCORD, NH 03301-3863
(603) 556-7101
(949) 404-6458
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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