Individual
SHANNON MARIE DESILETS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
184 MAMMOTH RD, LONDONDERRY, NH 03053-3254
(603) 434-8300
(603) 965-1057
Mailing address
206 MEADOW LARK DR, PEMBROKE, NH 03275-2918
(603) 210-1779
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2387
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08Y003331NH03
ANTHEM
NH
01
—
8933036
CIGNA
NH
Enumeration date
04/25/2007
Last updated
07/08/2007
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