| Wild Prairie Primary Care Pllc | |
|
240 Mechanic St Ste 201 Lebanon NH 03766-2617 | |
| (971) 235-9657 | |
| Not Available |
| Full Name | Wild Prairie Primary Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 240 Mechanic St Ste 201, Lebanon, New Hampshire |
| Authorized Official Name and Position | Juniper Vale (OWNER) |
| Authorized Official Contact | 9712359657 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Prairie Primary Care Pllc 240 Mechanic St Ste 201 Lebanon NH 03766-2617 Ph: () - | Wild Prairie Primary Care Pllc 240 Mechanic St Ste 201 Lebanon NH 03766-2617 Ph: (971) 235-9657 |
| NPI Number | 1720961865 |
|---|---|
| Provider Enumeration Date | 07/28/2025 |
| Last Update Date | 07/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720961865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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