MEDICARE: KERI ANN GREELY MSPT, CEIS

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	16804	MA

General Provider Information

NPI Number	:	1477738946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERI ANN GREELY MSPT, CEIS

Provider Business Mailing Address
First Line	:	60 FOLLY MILL RD
Second Line	:
City	:	SEABROOK
State	:	NH
Zip	:	03874-4014
Country	:	US
Telephone Number	:	603-474-7203
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 FOLLY MILL RD
Second Line	:
City	:	SEABROOK
State	:	NH
Zip	:	03874-4014
Country	:	US
Telephone Number	:	603-474-7203
Fax Number	:

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

Provider Enumeration Date	:	01/03/2008
Last Update Date	:	01/03/2008

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