Healthcare Provider Details
I. General information
NPI: 1366921421
Provider Name (Legal Business Name): TIMOTHY HUTCHINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/09/2018
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 OLD DOVER RD
ROCHESTER NH
03867-3464
US
IV. Provider business mailing address
113 CROSBY RD STE 1
DOVER NH
03820-4370
US
V. Phone/Fax
- Phone: 603-516-9300
- Fax: 603-740-9179
- Phone: 603-516-9300
- Fax: 603-740-9179
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: