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General NPI Number Information
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NPI Number | 1336099340
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Entity Type | Individual
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Provider Name | ANISSA AVILA PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 22 HUNT ST
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City | NASHUA
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State | NH
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Zip | 03060-4426
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Country | US
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Telephone | 603-889-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MELISSA DR
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-9448
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P23868
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP052167T
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License Number State | NH
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