Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 433 | NH |
NPI | 1225296841 |
---|---|
Provider Name | Timothy Dunn |
First Address | Keene, NH 03431-1719 |
Second Address | Keene, NH 03431-1719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 30/05/2008 |