Healthcare Provider Details

I. General information

NPI: 1033735253
Provider Name (Legal Business Name): DONALD F HUTCHINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 RICHARDSON ST
NORTHFIELD VT
05663-5644
US

IV. Provider business mailing address

126 N MAIN ST
WEST LEBANON NH
03784-1141
US

V. Phone/Fax

Practice location:
  • Phone: 802-485-3161
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number041-0000326
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0338
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: