Provider Demographics
NPI:1871670018
Name:GRIGG, DIANE M (LMT, CHT)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:GRIGG
Suffix:
Gender:F
Credentials:LMT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 A ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-2801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43 LOWELL RD
Practice Address - Street 2:NU LOOK HAIR AND BODY
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-2840
Practice Address - Country:US
Practice Address - Phone:603-566-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2691M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist