Provider Demographics
NPI:1356008692
Name:PACE, MAGGIE (DPT)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:PACE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:DIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:555 AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-4803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:435 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-4841
Practice Address - Country:US
Practice Address - Phone:603-666-5982
Practice Address - Fax:603-621-3492
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist