Healthcare Provider Details

I. General information

NPI: 1265604698
Provider Name (Legal Business Name): STEPHANIE M KEHAS MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 KINSLEY ST
NASHUA NH
03060
US

IV. Provider business mailing address

159 KINSLEY ST
NASHUA NH
03060
US

V. Phone/Fax

Practice location:
  • Phone: 603-889-1881
  • Fax: 603-889-1820
Mailing address:
  • Phone: 603-889-1881
  • Fax: 603-889-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2663
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number005242
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: