Healthcare Provider Details

I. General information

NPI: 1053470492
Provider Name (Legal Business Name): CPTE - MANCHESTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 S MAIN ST
MANCHESTER NH
03102-4405
US

IV. Provider business mailing address

522 AMHERST ST
NASHUA NH
03063-1019
US

V. Phone/Fax

Practice location:
  • Phone: 603-626-0760
  • Fax: 603-623-7441
Mailing address:
  • Phone: 603-880-0448
  • Fax: 603-881-5280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SANDRA RASTODER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 603-880-0448