Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | #0960 | NH |
N | 2251E1200X | Ergonomics | 0960 | NH |
N | 225XE1200X | Ergonomics | 0960 | NH |
NPI | 1962409722 |
---|---|
Provider Name | Mr. Ernest Matthew Roy |
First Address | Plymouth, NH 03264 |
Second Address | Plymouth, NH 03264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 09/09/2010 |