Facts
- Status
- A
- Credential
- DPT
- Type
- Individual
- Enumeration date
- 2020-08-20
- Last updated
- 2020-08-20
Specialties
Licenses
- License NH
- 4687
Location
- Practice location
- 1558 HOOKSETT RD STE 5
- City
- HOOKSETT NH
- Postal code
- 031061600
- Phone
- 603-695-6767
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.