Provider Demographics
NPI:1144489394
Name:PERREAULT, THOMAS W (DPT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:PERREAULT
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:73 NEWTON RD
Mailing Address - Street 2:STE 101
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2424
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:161 CORPORATE DR
Practice Address - Street 2:STE B
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-6825
Practice Address - Country:US
Practice Address - Phone:603-501-0581
Practice Address - Fax:603-501-0793
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2015-06-25
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Provider Licenses
StateLicense IDTaxonomies
NH33242251X0800X
MA18639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHT400115974Medicare PIN