Provider Demographics
NPI:1174820864
Name:BILLE, DAVID ANDREW (LMT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:BILLE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PROVINCE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SANBORNVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03872-3900
Mailing Address - Country:US
Mailing Address - Phone:603-522-3100
Mailing Address - Fax:603-522-5158
Practice Address - Street 1:40 PROVINCE LAKE RD
Practice Address - Street 2:
Practice Address - City:SANBORNVILLE
Practice Address - State:NH
Practice Address - Zip Code:03872-3900
Practice Address - Country:US
Practice Address - Phone:603-522-3100
Practice Address - Fax:603-522-5158
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3649M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist