Provider Demographics
NPI:1003785635
Name:PACKOWSKI, MICHELLE (PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:PACKOWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03826-2420
Mailing Address - Country:US
Mailing Address - Phone:603-819-3859
Mailing Address - Fax:
Practice Address - Street 1:26 COUNTRY RD
Practice Address - Street 2:
Practice Address - City:EAST HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03826-2420
Practice Address - Country:US
Practice Address - Phone:603-819-3859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-03
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13043225100000X
NH2655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist