Individual
MATTHEW THOMAS MARALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
232 MAIN ST, GORHAM, NH 03581-1500
(603) 466-5972
(603) 466-5974
Mailing address
107 LANCASTER RD, GORHAM, NH 03581-1427
(603) 466-2296
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2253
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004245
ANTHEM BCBS
NH
05
—
30392413
—
NH
01
—
5441373
HEALTHCARE VALUE MANAGEME
—
01
—
57401
GENESIS REHAB FOR CIGNA
NH
01
—
AA63614
HARVARD PILGRIM HEALTHCAR
NH
Enumeration date
03/22/2007
Last updated
07/08/2007
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