Basic Information
| Provider Information | |||||||||
| NPI: | 1366965915 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TURK | ||||||||
| FirstName: | JEFFREY | ||||||||
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| Credential: | COTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 774 | ||||||||
| Address2: | |||||||||
| City: | STODDARD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034640774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034462380 | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 RIVERMEAD RD | ||||||||
| Address2: | |||||||||
| City: | PETERBOROUGH | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034581788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039240062 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 224Z00000X | 0479 | NH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.