Healthcare Provider Details

I. General information

NPI: 1285960534
Provider Name (Legal Business Name): LEAH A HUTCHISON-DAME PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 QUAKER HWY
UXBRIDGE MA
01569-1628
US

IV. Provider business mailing address

60 QUAKER HWY
UXBRIDGE MA
01569-1628
US

V. Phone/Fax

Practice location:
  • Phone: 508-278-7810
  • Fax: 508-278-7855
Mailing address:
  • Phone: 508-278-7810
  • Fax: 508-278-7855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9088
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: