Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 1341 | NH |
NPI | 1003491515 |
---|---|
Provider Name | Mr. Branden Bilodeau |
First Address | Claremont, NH 03743-2969 |
Second Address | Claremont, NH 03743-2969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2021 |
Last Update Date | 16/03/2021 |