Healthcare Provider Details

I. General information

NPI: 1487852703
Provider Name (Legal Business Name): JENNIFER MCMAUGH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2007
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 WAUKEWAN ST
MEREDITH NH
03253-6023
US

IV. Provider business mailing address

PO BOX 1145
CENTER HARBOR NH
03226-1145
US

V. Phone/Fax

Practice location:
  • Phone: 603-279-6611
  • Fax:
Mailing address:
  • Phone: 603-253-9341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3785
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0843
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: