Provider Demographics
NPI:1669671574
Name:MACCAUSLAND, NANCY ELLEN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ELLEN
Last Name:MACCAUSLAND
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 ROUTE 140
Mailing Address - Street 2:UNIT #3
Mailing Address - City:GILMANTON
Mailing Address - State:NH
Mailing Address - Zip Code:03237
Mailing Address - Country:US
Mailing Address - Phone:917-239-1097
Mailing Address - Fax:
Practice Address - Street 1:30 COUNTY DR
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-2900
Practice Address - Country:US
Practice Address - Phone:603-527-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist