Individual
MATTHEW DAVIE MODELANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
17 RIVERSIDE ST, NASHUA, NH 03062-1304
(603) 889-0177
Mailing address
34 ONE STACK DR, BOW, NH 03304-4707
(603) 889-0177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3786
NH
Other
Enumeration date
05/10/2013
Last updated
05/10/2013
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