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General NPI Number Information
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NPI Number | 1477220556
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Entity Type | Individual
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Provider Name | NATHAN M STOVER PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 333 GREEN END AVE
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City | MIDDLETOWN
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State | RI
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Zip | 02842-5620
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Country | US
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Telephone | 401-849-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 2 RANGER CIR
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City | BATH
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State | ME
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Zip | 04530-4228
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Country | US
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Telephone | 207-522-5706
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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 | PT03465
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License Number State | RI
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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 | 4894
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 26131
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6038
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License Number State | ME
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 13225
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License Number State | MN
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