Individual
MAKENNA BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
39 BELL RD, PLYMOUTH, NH 03264-3500
(518) 593-8004
Mailing address
39 BELL RD, PLYMOUTH, NH 03264-3500
(518) 593-8004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305216255
VA
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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