Jason Dykstra
Individual provider Active NPI Physical Therapy Assistant · Salem, NH
NPI 1215219282 · NPPES record last updated Sep 15, 2011
Key facts
- NPI
- 1215219282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2084438 (TX)
- Practice address
- 2 Keewaydin Dr
Salem, NH 03079-2839 - Phone
- (800) 995-2673
- Fax
- (866) 420-1055
- NPI assigned
- Sep 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2084438 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2084438 | TX | Yes |
Addresses
Primary practice location
2 Keewaydin Dr
Salem, NH 03079-2839
Mailing address
2 Keewaydin Dr
Salem, NH 03079-2839
Phone (800) 995-2673
Other providers in Salem, NH
- Colleen Dufresne
- Deborah R Dukes
- Karen Ann Dunn
- Darby Ann Dupuis
- Jeremy Durst
- Kaylee Earll
- Adam Guy Eaton
- Tara Eberly
- Rachel Ann Ebert
- Kimberly Eddy
All providers in Salem, NH · Physical Therapy Assistant in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.