=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154943173
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN RITENOUR PT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2020
-----------------------------------------------------
Last Update Date | 05/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 67 CUMMINGS RD
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03755-1263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-653-8573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 90 VIEW PL
-----------------------------------------------------
City | GRANTHAM
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03753-3148
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-873-3384
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------