Individual
RANDY G BERUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
700 LAKE AVE, MANCHESTER, NH 03103-2734
(603) 625-1864
(603) 668-7181
Mailing address
700 LAKE AVE, MANCHESTER, NH 03103-2734
(603) 625-1864
(603) 668-7181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1772
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30392139
—
NH
Enumeration date
07/07/2005
Last updated
07/11/2007
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