Provider Demographics
NPI:1255487005
Name:MCCANN, AMANDA J (PT)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:J
Last Name:MCCANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 MERRIT PARKWAY
Mailing Address - Street 2:SNHRC
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062
Mailing Address - Country:US
Mailing Address - Phone:603-595-0230
Mailing Address - Fax:603-595-0936
Practice Address - Street 1:5 MERIT PKWY
Practice Address - Street 2:SNHRC
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3029
Practice Address - Country:US
Practice Address - Phone:603-595-0230
Practice Address - Fax:603-595-0936
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH2762225100000X
MA11502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist