Gary Tilton, PTA

Individual provider Active NPI Physical Therapy Assistant · Gorham, NH

NPI 1235378647 · NPPES record last updated Feb 9, 2009

Key facts

NPI
1235378647
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
0255 (NH)
Practice address
40 Exchange St
Gorham, NH 03581-1604
Phone
(603) 466-5972
Fax
(603) 466-5974
NPI assigned
Feb 9, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0255NHMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0255 NH Yes

Addresses

Primary practice location

40 Exchange St
Gorham, NH 03581-1604

Mailing address

40 Exchange St
Gorham, NH 03581-1604
Phone (603) 466-5972

Other providers in Gorham, NH

All providers in Gorham, NH · Physical Therapy Assistant in New Hampshire

Sources for this page

Verify at the official NPI Registry.