Provider Demographics
NPI:1679345219
Name:MAGGIO, MARC MARIO (PT)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:MARIO
Last Name:MAGGIO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 KNOWLTON RD
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-3013
Mailing Address - Country:US
Mailing Address - Phone:339-206-1403
Mailing Address - Fax:
Practice Address - Street 1:6 KNOWLTON RD
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-3013
Practice Address - Country:US
Practice Address - Phone:339-206-1403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist