Most Relevant Information
Provider Data
| NPI Number: | 1003422809 |
| Provider Name: | MAKINA ITCHKAVICH-LEVASSEUR MS, ATC, LAT |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 0686 |
Most Important Dates
| Enumeration Date: | 09/17/2020 |
| Last Updated: | 09/17/2020 |
Provider Practice Location
40 UNIVERSITY DR
RINDGE
NH
034615045
Practice Location Phone/Fax
| Phone: | 6038991142 |
| Fax: |
Provider Mailing Location
223 BANCROFT RD
RINDGE
NH
034615906
Provider Mailing Phone/Fax
| Phone: | 6036301166 |
| Fax: |