Basic Information
| Provider Information | |||||||||
| NPI: | 1669021515 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HIXON | ||||||||
| FirstName: | TESS | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2019 | ||||||||
| Address2: | |||||||||
| City: | SANDWICH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 025638019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087789336 | ||||||||
| FaxNumber: | 5088880165 | ||||||||
| Practice Location | |||||||||
| Address1: | 130 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026013825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087716685 | ||||||||
| FaxNumber: | 5088880165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2019 | ||||||||
| LastUpdateDate: | 09/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 24507 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.