Healthcare Provider Details

I. General information

NPI: 1073082673
Provider Name (Legal Business Name): MICHAELA CIOFFREDI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2018
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 ETNA RD
LEBANON NH
03766-1559
US

IV. Provider business mailing address

4135 QUEST DR
EUGENE OR
97402-8768
US

V. Phone/Fax

Practice location:
  • Phone: 603-643-7788
  • Fax: 603-643-0022
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP022568T
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number63052
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: