Healthcare Provider Details

I. General information

NPI: 1023115904
Provider Name (Legal Business Name): MELISSA LEE LANOIE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA LEE KERSHAW PT

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1558 HOOKSETT RD STE 5
HOOKSETT NH
03106-1600
US

IV. Provider business mailing address

1558 HOOKSETT RD STE 5
HOOKSETT NH
03106-1600
US

V. Phone/Fax

Practice location:
  • Phone: 603-695-6767
  • Fax: 603-695-6766
Mailing address:
  • Phone: 603-695-6767
  • Fax: 603-695-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3162
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: