Provider Demographics
NPI:1811355969
Name:HARDY, ROSALYN (LMT)
Entity type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 PORTSMOUTH AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2133
Mailing Address - Country:US
Mailing Address - Phone:603-244-3009
Mailing Address - Fax:
Practice Address - Street 1:92 PORTSMOUTH AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2133
Practice Address - Country:US
Practice Address - Phone:603-244-3009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3518M174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist