Provider Demographics
NPI:1609653534
Name:PREISENDORFER, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:PREISENDORFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 UHLMAN DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:NH
Mailing Address - Zip Code:03285-6427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2115 US ROUTE 3
Practice Address - Street 2:
Practice Address - City:CAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03223-4500
Practice Address - Country:US
Practice Address - Phone:603-455-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6152M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist