Provider Demographics
NPI:1548421472
Name:CAVEZZALI, GILLIAN MARGARET (PT)
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:MARGARET
Last Name:CAVEZZALI
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 1:33 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1117
Mailing Address - Country:US
Mailing Address - Phone:603-536-5165
Mailing Address - Fax:
Practice Address - Street 1:16 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1126
Practice Address - Country:US
Practice Address - Phone:603-238-2308
Practice Address - Fax:603-238-2138
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2054225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist