Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 3469 | NH |
NPI | 1255755666 |
---|---|
Provider Name | Saral Gupta |
First Address | Gorham, NH 03581-1621 |
Second Address | Berlin, NH 03570-3130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2014 |
Last Update Date | 06/02/2014 |