Provider Demographics
NPI:1760588487
Name:SALKA, KERRIE ANNE (PT)
Entity Type:Individual
Prefix:MS
First Name:KERRIE
Middle Name:ANNE
Last Name:SALKA
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 1:1225 BODWELL RD
Mailing Address - Street 2:APT 12
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5815
Mailing Address - Country:US
Mailing Address - Phone:603-644-1539
Mailing Address - Fax:
Practice Address - Street 1:525 CLINTON ST
Practice Address - Street 2:
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-4609
Practice Address - Country:US
Practice Address - Phone:603-226-3212
Practice Address - Fax:603-226-3354
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH21101YMedicare UPIN