Healthcare Provider Details

I. General information

NPI: 1215366950
Provider Name (Legal Business Name): KARIANN GAUDETTE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BALDWIN ST
FRANKLIN NH
03235-2000
US

IV. Provider business mailing address

109 PERKINS RD
SANBORNTON NH
03269-2403
US

V. Phone/Fax

Practice location:
  • Phone: 603-934-2541
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3829
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: