Provider Demographics
NPI:1144241530
Name:GREENWOOD, MELANIE SUZZETTE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:SUZZETTE
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 HURRICANE RD
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2175
Mailing Address - Country:US
Mailing Address - Phone:603-355-8982
Mailing Address - Fax:
Practice Address - Street 1:739 HURRICANE RD
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2175
Practice Address - Country:US
Practice Address - Phone:603-355-8982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH08Y003532NH02OtherBLUE CROSS AND BLUE SHIEL
NHAA57432OtherHARVARD PILGRAM
NH5112129004OtherCINGNA
NH6404240OtherUNITED HEALTH CARE
NH30393748Medicaid
NHRE6426Medicare ID - Type UnspecifiedPHYSICAL THERAPIST
NH30393748Medicaid