Healthcare Provider Details

I. General information

NPI: 1568582716
Provider Name (Legal Business Name): REBECCA MARIE GUIBORD MS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 HALL ST UNIT H
CONCORD NH
03301-3478
US

IV. Provider business mailing address

20 MILLSTONE TER
BEDFORD NH
03110-4236
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-4540
  • Fax: 603-228-6384
Mailing address:
  • Phone: 603-488-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2781
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: