Provider Demographics
NPI:1427492461
Name:PELLETIER, MEGHAN E (PT DPT)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:E
Last Name:PELLETIER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1156
Mailing Address - Country:US
Mailing Address - Phone:603-339-0168
Mailing Address - Fax:
Practice Address - Street 1:21 SEARLES RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1203
Practice Address - Country:US
Practice Address - Phone:603-890-1290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3597225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist