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Individual

CHARLENE DEMARCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
555 AUBURN ST, MANCHESTER, NH 03103-4803
(603) 623-8863
Mailing address
555 AUBURN ST, MANCHESTER, NH 03103-4803

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1321
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0803369Y0NH01
ANTHEM
NH
01
4126885
MVP
NH
Enumeration date
03/08/2007
Last updated
04/27/2010
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