Jonathan Daley, PTA
Individual provider Active NPI Physical Therapy Assistant · Lebanon, NH
NPI 1255716627 · NPPES record last updated Jul 27, 2015
Key facts
- NPI
- 1255716627
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 1194 (NH)
- Practice address
- 24 Old Etna Rd
Lebanon, NH 03766-1937 - Phone
- (603) 488-2234
- NPI assigned
- Jul 27, 2015
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1194 | NH | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1194 | NH | Yes |
Addresses
Primary practice location
24 Old Etna Rd
Lebanon, NH 03766-1937
Mailing address
19 Charles St
19 Charles St
Claremont, NH 03743-3112
Phone (603) 504-6531
Other providers in Lebanon, NH
- Alicia True Dagrosa
- Lawrence Marc Dagrosa
- Jorda Daigneault
- Michael Frederick Daily
- Alton Brooks Parker Daley IV
- Taylor Daley
- Claudia Dalterio
- Erin Dalton
- Brendan Dundurs Daly
- Ella Anne Damiano
All providers in Lebanon, 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 Jul 27, 2015. 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.