| Shad Hansen, | |
|
17 Riverside St, Suite 203, Nashua, NH 03062-1304 | |
| (603) 889-0177 | |
| Not Available |
| Full Name | Shad Hansen |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 17 Riverside St, Nashua, New Hampshire |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720472483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 2840 (New Hampshire) | Primary |
| Provider Name | Derry Sports & Rehab Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1487670386 PECOS PAC ID: 1052666807 Enrollment ID: O20180619001012 |
| Mailing Address | Practice Location Address |
|---|---|
| Shad Hansen, 17 Riverside St, Suite 203, Nashua, NH 03062-1304 Ph: (603) 889-0177 | Shad Hansen, 17 Riverside St, Suite 203, Nashua, NH 03062-1304 Ph: (603) 889-0177 |
Alicia M Brown, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 460 Amherst St, Southern Nh Rehabilitation Center, Nashua, NH 03063 Phone: 603-577-8400 Fax: 603-577-8405 | |
Catherine Amy Walsh, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 522 Amherst St, Ste 22, Nashua, NH 03063 Phone: 603-880-0448 Fax: 603-881-5280 | |
Melissa Campbell, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 460 Amherst St, Snhhs, Nashua, NH 03063 Phone: 603-579-3601 | |
Deepali Batish, Physical Therapist Medicare: Medicare Enrolled Practice Location: 55 Harris Rd, Nashua, NH 03062 Phone: 603-888-1573 | |
Aubrey Houston, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 76 Northeastern Blvd Ste 40, Nashua, NH 03062 Phone: 603-882-4500 Fax: 603-882-4545 | |
Meredith Frazier, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 76 Northeastern Blvd Ste 40, Nashua, NH 03062 Phone: 603-882-4500 | |
Nicole Harrison, Physical Therapist Medicare: Medicare Enrolled Practice Location: 157 Main Dunstable Rd Ste 202, Nashua, NH 03060 Phone: 603-595-7511 |