Provider Demographics
NPI:1992955439
Name:MARGGRAF, CORINNE JEAN (LMT)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:JEAN
Last Name:MARGGRAF
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 EASTERN AVE
Mailing Address - Street 2:# 202
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4632
Mailing Address - Country:US
Mailing Address - Phone:603-231-9851
Mailing Address - Fax:
Practice Address - Street 1:8030 S WILLOW ST
Practice Address - Street 2:SUITE 4
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2319
Practice Address - Country:US
Practice Address - Phone:603-647-2566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-21
Last Update Date:2008-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2922M172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist