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General NPI Number Information
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NPI Number | 1902449655
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Entity Type | Individual
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Provider Name | ALLISON M. GRANUCCI DPT
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Gender | Female
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 166 S RIVER RD STE 104
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City | BEDFORD
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State | NH
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Zip | 03110-6928
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Country | US
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Telephone | 603-782-3039
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Fax | 603-782-3667
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Provider Business Mailing Address
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Address Line | 2440 GOLD STAR HWY UNIT 201
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City | MYSTIC
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State | CT
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Zip | 06355-1180
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Country | US
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Telephone | 860-536-1001
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Fax | 860-536-1527
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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 | 12338
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License Number State | CT
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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 | 5097
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License Number State | NH
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