Provider Demographics
NPI:1891268306
Name:LIONBERGER, CHAD GERALD (DPT)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:GERALD
Last Name:LIONBERGER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CROSBY ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4707
Mailing Address - Country:US
Mailing Address - Phone:603-673-7061
Mailing Address - Fax:
Practice Address - Street 1:40 CROSBY ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4707
Practice Address - Country:US
Practice Address - Phone:603-673-7061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-08
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013692225100000X
NHCP044942T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist