Provider Demographics
NPI:1922142082
Name:RAWDING-ANDERSON, PATTI-JEAN
Entity Type:Individual
Prefix:
First Name:PATTI-JEAN
Middle Name:
Last Name:RAWDING-ANDERSON
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 1:431 MAIN STREET
Mailing Address - Street 2:PO BOX 370
Mailing Address - City:ROLLINSFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03869
Mailing Address - Country:US
Mailing Address - Phone:603-749-4846
Mailing Address - Fax:
Practice Address - Street 1:61 ROUTE 27 # 107
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-1273
Practice Address - Country:US
Practice Address - Phone:603-895-1522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1202225100000X
MA4527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH781331OtherMVP
NH0803279Y0NH01OtherANTHEM