Provider Demographics
NPI:1831213842
Name:MELANIE GREENWOOD
Entity type:Organization
Organization Name:MELANIE GREENWOOD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-252-4405
Mailing Address - Street 1:739 HURRICANE RD
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2175
Mailing Address - Country:US
Mailing Address - Phone:603-252-4405
Mailing Address - Fax:603-399-9080
Practice Address - Street 1:739 HURRICANE RD
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2175
Practice Address - Country:US
Practice Address - Phone:603-252-4405
Practice Address - Fax:603-399-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH25342251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHAA57432OtherHARVARD PILGRIM
NH50Y855000NH01OtherANTHEM BLUE CROSS
NH30393748Medicaid
NHAA57432OtherHARVARD PILGRIM
NH21170YMedicare UPIN