Healthcare Provider Details

I. General information

NPI: 1437220076
Provider Name (Legal Business Name): PROCARE PHYSICAL THERAPY AND HAND CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 US HIGHWAY 1 BYP SUITE 1
PORTSMOUTH NH
03801-5332
US

IV. Provider business mailing address

150 US HIGHWAY 1 BYP SUITE 1
PORTSMOUTH NH
03801-5332
US

V. Phone/Fax

Practice location:
  • Phone: 603-431-1121
  • Fax:
Mailing address:
  • Phone: 603-431-1121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MAYO NOERDLINGER
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 603-431-1121