Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2243 | NH |
NPI | 1194060996 |
---|---|
Provider Name | Steven Silcocks |
First Address | Keene, NH 03431-4132 |
Second Address | Winchester, NH 03470-2806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2012 |
Last Update Date | 05/12/2012 |