Organization
FURTHER CARE P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHEL JUAN RONDON VIDAL M.D. (PRESIDENT)
(603) 294-4424
Entity
Organization
Contact information
Practice address
330 BORTHWICK AVE STE 111, PORTSMOUTH, NH 03801-7110
(603) 294-4424
(603) 319-1603
Mailing address
330 BORTHWICK AVE STE 111, PORTSMOUTH, NH 03801-7110
(603) 294-4424
(603) 319-1603
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
14095
NH
2084P0805X
Geriatric Psychiatry Physician
14095
NH
Other
Enumeration date
11/25/2013
Last updated
11/25/2013
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