Provider Demographics
NPI:1679226492
Name:AYER, AMANDA M (PTA, LMT, CMT, CRM)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:M
Last Name:AYER
Suffix:
Gender:F
Credentials:PTA, LMT, CMT, CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 OPERA HOUSE SQUARE
Mailing Address - Street 2:SUITE 410, BOX 14
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743
Mailing Address - Country:US
Mailing Address - Phone:603-276-8240
Mailing Address - Fax:
Practice Address - Street 1:24 OPERA HOUSE SQ STE 410
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-5408
Practice Address - Country:US
Practice Address - Phone:603-276-8240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3894225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist