Provider Demographics
NPI:1669728275
Name:SANTOS, ERIC (PT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:SANTOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 JOCKEY HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:LANDAFF
Mailing Address - State:NH
Mailing Address - Zip Code:03585
Mailing Address - Country:US
Mailing Address - Phone:401-935-8925
Mailing Address - Fax:401-737-4811
Practice Address - Street 1:5 S MAIN STREET
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:NH
Practice Address - Zip Code:03585
Practice Address - Country:US
Practice Address - Phone:401-935-8925
Practice Address - Fax:855-595-2724
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist