Organization
INTEGRATIVE OSTEOPATHIC MEDICINE & HEALING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONQUILLE BOUCHARD D.O. (OWNER)
(603) 641-2070
Entity
Organization
Contact information
Practice address
16 HIGH ST, SUITE 2, MANCHESTER, NH 03101-1610
(603) 641-2070
(603) 641-8084
Mailing address
16 HIGH ST, SUITE 2, MANCHESTER, NH 03101-1610
(603) 641-2070
(603) 641-8084
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
16816
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881997716
TYPE 1 NPI
NH
Enumeration date
04/21/2015
Last updated
04/21/2015
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