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General NPI Number Information
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NPI Number | 1295976132
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Entity Type | Individual
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Provider Name | JOHAN JULES UYLENBROECK PT, MBA, CLT, LSVT
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Gender | Male
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 319 E DUNSTABLE RD
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City | NASHUA
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State | NH
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Zip | 03062-4207
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Country | US
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Telephone | 603-273-6459
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Fax |
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Provider Business Mailing Address
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Address Line | 26 MASSACHUSETTS AVE
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City | MEREDITH
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State | NH
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Zip | 03253-5710
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Country | US
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Telephone | 603-366-8508
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 040.0003053
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1918
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License Number State | NH
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