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NPI Code Detail

MEDICARE: COURTNEY ANN UPDEGROVE OTR/L

MEDICARE: COURTNEY ANN UPDEGROVE OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist3865NH

General Provider Information

NPI Number : 1629357322
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY ANN UPDEGROVE OTR/L
Provider Business Mailing Address
First Line : 124 HALL ST STE H
Second Line :
City : CONCORD
State : NH
Zip : 03301-3442
Country : US
Telephone Number : 603-228-9160
Fax Number : 603-224-2776
Provider Business Practice Location Address
First Line : 124 HALL ST STE H
Second Line :
City : CONCORD
State : NH
Zip : 03301-3442
Country : US
Telephone Number : 603-228-9160
Fax Number : 603-224-2776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2011
Last Update Date : 12/03/2024

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Directions to “ COURTNEY ANN UPDEGROVE OTR/L” Practice Location

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