Provider Demographics
NPI:1134770266
Name:GAYTON, CASIE (PT)
Entity type:Individual
Prefix:
First Name:CASIE
Middle Name:
Last Name:GAYTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CASIE
Other - Middle Name:
Other - Last Name:DAMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 S RIVER RD
Mailing Address - Street 2:UNIT 58
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6751
Mailing Address - Country:US
Mailing Address - Phone:603-626-4205
Mailing Address - Fax:603-666-6617
Practice Address - Street 1:340 GRANITE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-4000
Practice Address - Country:US
Practice Address - Phone:603-626-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH4539OtherOFFICE OF ALLIED HEALTH