Provider Demographics
NPI:1801059670
Name:HAGLEY, GREGORY WILLIAM (DPT)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:WILLIAM
Last Name:HAGLEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 GRIFFIN RD
Mailing Address - Street 2:STE 3
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7131
Mailing Address - Country:US
Mailing Address - Phone:603-433-2101
Mailing Address - Fax:603-427-6841
Practice Address - Street 1:150 GRIFFIN RD
Practice Address - Street 2:STE 3
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7131
Practice Address - Country:US
Practice Address - Phone:603-433-2101
Practice Address - Fax:603-427-6841
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3327225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1801059670OtherANTHEM