Healthcare Provider Details

I. General information

NPI: 1811014863
Provider Name (Legal Business Name): JESSICA LEE BITTLE MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BALDWIN ST
FRANKLIN NH
03235-2000
US

IV. Provider business mailing address

1 SHARON DR
BOW NH
03304-4325
US

V. Phone/Fax

Practice location:
  • Phone: 603-934-2541
  • Fax:
Mailing address:
  • Phone: 603-491-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2549
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: