Basic Information
| Provider Information | |||||||||
| NPI: | 1568619658 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PEOPLEFIRST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 HARRIS RD | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030622145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038881573 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 HARRIS RD | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030622145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038881573 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2008 | ||||||||
| LastUpdateDate: | 08/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | DUBE | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 6038881573 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 2127 | NH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.