Individual
KIMBERLY GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, MMP
Contact information
Practice address
575 S WILLOW ST, MANCHESTER, NH 03103-5713
(603) 232-3233
Mailing address
575 S WILLOW ST, MANCHESTER, NH 03103-5713
(603) 921-0087
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
3485M
NH
225700000X
Massage Therapist
Primary
3485M
NH
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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