Healthcare Provider Details

I. General information

NPI: 1821298126
Provider Name (Legal Business Name): CIOFFREDI & ASSOCIATES PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 ETNA RD
LEBANON NH
03766-1454
US

IV. Provider business mailing address

PO BOX 727
LEBANON NH
03766-0727
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberNH0490
License Number StateNH

VIII. Authorized Official

Name: MR. WILLIAM J CIOFFREDI
Title or Position: CEO
Credential: PT
Phone: 603-643-7788