Doctor Name: | MR. JOSEPH DATTILO |
NPI Number: | 1194710756 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, C.PED |
License Number: | 1866 |
Business Practice Address: | 64 Portsmouth Ave Suite 5 Stratham, NH - 038852523 |
Business Phone Number: | 6037728222 |
Business Fax Number: | 6037726738 |
Mailing Address: | 37 Route 236, 112 KITTERY |
State: | ME |
Postal Code: | 039046000 |
Phone Number: | 2074392675 |
Fax Number: | 2074394965 |
NPI Enumeration Date: | 09/20/2005 |
NPI Last Update Date: | 09/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1866 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |