Basic Information
| Provider Information | |||||||||
| NPI: | 1306087473 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUXBURY | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | R | ||||||||
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| NameSuffix: | JR. | ||||||||
| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 COMMERCE WAY 120 | ||||||||
| Address2: | |||||||||
| City: | PORTSMOUTH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038018200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034278066 | ||||||||
| FaxNumber: | 6035010495 | ||||||||
| Practice Location | |||||||||
| Address1: | 64 PORTSMOUTH AVE | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | STRATHAM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038856552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037728222 | ||||||||
| FaxNumber: | 6037726738 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2009 | ||||||||
| LastUpdateDate: | 08/31/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 3400 | NH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.