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Individual

JAVIER A CORREDOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3 SUNDIAL AVE, MANCHESTER, NH 03103-7230
(603) 296-6317
Mailing address
10 ASHWOOD CT, ATKINSON, NH 03811-2722

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2839
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08Y011351NH01
ANTHEM INDIV #
NH
01
099268
ANTHEM MAINE
ME
05
30394987
NH
01
AA79032
HARVARD PILGRIM GROUP #
01
RE8968
MEDICARE GROUP #
NH
Enumeration date
12/15/2006
Last updated
07/26/2010
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