Organization
HEALTHY LIVING FAMILY PRACTICE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN J RAJCHEL (OFFICE MANAGER/VP)
(603) 895-1658
Entity
Organization
Contact information
Practice address
74 MAIN ST, RAYMOND, NH 03077
(603) 895-1658
(603) 895-9394
Mailing address
PO BOX 1139, RAYMOND, NH 03077-1139
(603) 895-1658
(603) 895-9394
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
026533-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30346414
—
NH
01
—
AA120549
HARVARD PILGRIM
—
01
—
NP513401
MEDICARE
—
Enumeration date
06/29/2009
Last updated
06/29/2009
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