Healthcare Provider Details

I. General information

NPI: 1386812865
Provider Name (Legal Business Name): MICHELLE M SARGENT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2008
Last Update Date: 02/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 WASHINGTON RD
RYE NH
03870-2318
US

IV. Provider business mailing address

459 PORTSMOUTH AVE
GREENLAND NH
03840-2221
US

V. Phone/Fax

Practice location:
  • Phone: 603-964-8144
  • Fax:
Mailing address:
  • Phone: 603-433-4727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3184
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT2116
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: