Provider Demographics
NPI:1255769923
Name:STARRY BROOK NATURAL MEDICINE, LLC
Entity type:Organization
Organization Name:STARRY BROOK NATURAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:AGNES
Authorized Official - Last Name:GIARD
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:603-583-5181
Mailing Address - Street 1:14 BOW ST
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2828
Mailing Address - Country:US
Mailing Address - Phone:603-583-5181
Mailing Address - Fax:603-583-5194
Practice Address - Street 1:60 SOUTH RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:NH
Practice Address - Zip Code:03037
Practice Address - Country:US
Practice Address - Phone:603-583-5181
Practice Address - Fax:844-364-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH82175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty