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Individual

SCOTT CORLISS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NCTMB

Contact information

Practice address
14 MANCHESTER SQ STE 120, PORTSMOUTH, NH 03801-8003
(603) 812-7535
(603) 766-3140
Mailing address
14 MANCHESTER SQ, #120, PORTSMOUTH, NH 03801-8001
(603) 812-7535
(603) 766-3140

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2991M
NH

Other

Enumeration date
11/27/2013
Last updated
11/26/2014
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