Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1194 | NH |
NPI | 1124362165 |
---|---|
Provider Name | Brian Hinton |
First Address | Bedford, NH 03110-6215 |
Second Address | Bedford, NH 03110-6215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2012 |
Last Update Date | 15/11/2012 |