Basic Information
| Provider Information | |||||||||
| NPI: | 1285260323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MACKILLOP | ||||||||
| FirstName: | MAGGIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 SUNSET LN | ||||||||
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| City: | HANCOCK | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034496100 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5 NURSING HOME DR | ||||||||
| Address2: | |||||||||
| City: | CLAREMONT | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037437344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035429511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2020 | ||||||||
| LastUpdateDate: | 03/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 1355 | NH | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.