Individual
MRS. MARY ELIZABETH FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,RPT
Contact information
Practice address
654 WALLIS ROAD, RYE, NH 03870-2245
(603) 964-8819
Mailing address
654 WALLIS ROAD, RYE, NH 03870-2245
(603) 964-8819
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0188
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0806320Y0NH01
PHYSICAL THERAPIST
NH
05
—
30003796
—
NH
Enumeration date
05/02/2007
Last updated
07/09/2007
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