Individual
MR. GREGORY M LAVALLEE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSPT
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
2261
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0809303Y0NH01
ANTHEM BCBS
NH
05
—
30392142
—
NH
Enumeration date
07/07/2005
Last updated
07/08/2007
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