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General NPI Number Information
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NPI Number | 1639274079
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Entity Type | Organization
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Legal Business Name | COTTAGE ORTHOPEDICS PLLC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15 TOWN WEST RD
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City | PLYMOUTH
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State | NH
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Zip | 03264
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Country | US
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Telephone | 603-536-1565
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Fax | 603-536-1200
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Provider Business Mailing Address
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Address Line | 15 TOWN WEST RD
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City | PLYMOUTH
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State | NH
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Zip | 03264
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Country | US
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Telephone | 603-536-1565
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Fax | 603-536-1200
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARY L MAUCHLY
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Credential |
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Telephone | 603-536-1565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0320000417
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 8934
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License Number State | NH
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