Provider Demographics
NPI:1952944019
Name:GOSSELIN, HOLLY ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:GOSSELIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MAIN DUNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3640
Mailing Address - Country:US
Mailing Address - Phone:603-881-5554
Mailing Address - Fax:603-595-7511
Practice Address - Street 1:155 MAIN DUNSTABLE RD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3640
Practice Address - Country:US
Practice Address - Phone:603-881-5554
Practice Address - Fax:603-595-7511
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24465225100000X
NH4591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist