Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | NA | NH |
NPI | 1902397011 |
---|---|
Provider Name | Daniele A Crutcher |
First Address | Stratham, NH 03885-6528 |
Second Address | Stratham, NH 03885-6528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2018 |
Last Update Date | 24/05/2018 |