Provider Demographics
NPI:1205413143
Name:KNUUTTUNEN, JANICE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARIE
Last Name:KNUUTTUNEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 PINE RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SANDOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03873-2222
Mailing Address - Country:US
Mailing Address - Phone:603-490-6315
Mailing Address - Fax:
Practice Address - Street 1:30 GREENOUGH RD
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2724
Practice Address - Country:US
Practice Address - Phone:603-382-6425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1138225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3075434Medicaid