Healthcare Provider Details

I. General information

NPI: 1235668195
Provider Name (Legal Business Name): MICHAEL PIOTROWSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 06/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 ROCHESTER HILL RD
ROCHESTER NH
03867-3216
US

IV. Provider business mailing address

4 BROOKMOOR RD
DOVER NH
03820-5338
US

V. Phone/Fax

Practice location:
  • Phone: 603-335-3955
  • Fax:
Mailing address:
  • Phone: 603-343-4849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number1096
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: