Provider Demographics
NPI:1417045014
Name:GLOEKLER, DENISE MATTHEWS (PT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MATTHEWS
Last Name:GLOEKLER
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 1:3 SURREY COACH LN
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304-4124
Mailing Address - Country:US
Mailing Address - Phone:603-224-0274
Mailing Address - Fax:
Practice Address - Street 1:3 SURREY COACH LN
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-4124
Practice Address - Country:US
Practice Address - Phone:603-224-0274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0663225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0663OtherPHYSICAL THERAPIST