Doctor Name: | SCOTT CORLISS |
NPI Number: | 1801227996 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NCTMB |
License Number: | 2991M |
Business Practice Address: | 14 Manchester Sq Ste 120 Portsmouth, NH - 038018003 |
Business Phone Number: | 6038127535 |
Business Fax Number: | 6037663140 |
Mailing Address: | 14 Manchester Sq, #120 PORTSMOUTH |
State: | NH |
Postal Code: | 038018001 |
Phone Number: | 6038127535 |
Fax Number: | 6037663140 |
NPI Enumeration Date: | 11/27/2013 |
NPI Last Update Date: | 11/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2991M |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |