Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 4449 | NH |
NPI | 1053880278 |
---|---|
Provider Name | Alex Rigazio |
First Address | Windham, NH 03087-2014 |
Second Address | Windham, NH 03087-2014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2018 |
Last Update Date | 16/11/2018 |