Individual
MARK GIOVAGNOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
15 LAKE ST, ENFIELD, NH 03748-3587
(603) 632-1273
Mailing address
15 LAKE ST, ENFIELD, NH 03748-3587
(603) 632-1273
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0621
NH
Other
Enumeration date
06/03/2011
Last updated
06/03/2011
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