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NPI Code Detail

MEDICARE: MRS. NANCY ANN BILODEAU PTA

MEDICARE: MRS. NANCY ANN BILODEAU PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant0870NH

General Provider Information

NPI Number : 1053435768
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NANCY ANN BILODEAU PTA
Provider Business Mailing Address
First Line : 25 OLD MOUNTAIN RD
Second Line :
City : NORTHWOOD
State : NH
Zip : 03261-4203
Country : US
Telephone Number : 603-305-1222
Fax Number :
Provider Business Practice Location Address
First Line : 29 CENTER ST
Second Line :
City : GOFFSTOWN
State : NH
Zip : 03045-2948
Country : US
Telephone Number : 603-497-2376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 06/04/2009

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