Provider Demographics
NPI:1578611190
Name:WARNER, MARGUERITE (MSPT)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:HENNIKER
Mailing Address - State:NH
Mailing Address - Zip Code:03242-3178
Mailing Address - Country:US
Mailing Address - Phone:603-428-3844
Mailing Address - Fax:603-428-8507
Practice Address - Street 1:246 PLEASANT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-4540
Practice Address - Fax:603-228-7384
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12872251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30001872Medicaid