Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 4017 | NH |
NPI | 1073973699 |
---|---|
Provider Name | Meredith Frazier |
First Address | Nashua, NH 03062-3178 |
Second Address | Nashua, NH 03062-3178 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2016 |
Last Update Date | 10/01/2019 |