Healthcare Provider Details

I. General information

NPI: 1174754907
Provider Name (Legal Business Name): DOMINIQUE DA SILVA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 07/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BALDWIN ST
FRANKLIN NH
03235-2000
US

IV. Provider business mailing address

51 PEASLEE HILL RD
WEARE NH
03281-4634
US

V. Phone/Fax

Practice location:
  • Phone: 603-934-2541
  • Fax:
Mailing address:
  • Phone: 603-545-9924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3436
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: