Basic Information
Provider Information
NPI: 1104372341
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRAMS
FirstName: DAVID
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherLastNameType:  
Mailing Information
Address1: 73 NEWTON RD UNIT 101
Address2:  
City: PLAISTOW
State: NH
PostalCode: 038652440
CountryCode: US
TelephoneNumber: 9783887272
FaxNumber: 9783887373
Practice Location
Address1: 282 ROUTE 101 UNIT 11
Address2:  
City: AMHERST
State: NH
PostalCode: 030311706
CountryCode: US
TelephoneNumber: 6036725125
FaxNumber: 6036725126
Other Information
ProviderEnumerationDate: 08/28/2016
LastUpdateDate: 10/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X22517MAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X4483NHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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