Healthcare Provider Details

I. General information

NPI: 1134865520
Provider Name (Legal Business Name): CADENCE PROCTOR MSPT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 WAKEFIELD ST
ROCHESTER NH
03867-1300
US

IV. Provider business mailing address

2 GOSLIN WAY
NEW DURHAM NH
03855-2458
US

V. Phone/Fax

Practice location:
  • Phone: 207-229-3787
  • Fax:
Mailing address:
  • Phone: 207-229-3787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2992
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: