MEDICARE: KRISTEN TRAHAN

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
1	225100000X	Physical Therapist	2169	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467423723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN TRAHAN

Provider Business Mailing Address
First Line	:	262 COTTAGE ST
Second Line	:	SUITE 130
City	:	LITTLETON
State	:	NH
Zip	:	03561-4101
Country	:	US
Telephone Number	:	603-444-9865
Fax Number	:	603-444-9865

Provider Business Practice Location Address
First Line	:	262 COTTAGE ST
Second Line	:	SUITE 130
City	:	LITTLETON
State	:	NH
Zip	:	03561-4101
Country	:	US
Telephone Number	:	603-444-9865
Fax Number	:	603-444-9865

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	11/04/2008

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Directions to “ KRISTEN TRAHAN ” Practice Location

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