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Individual

MR. THOMAS GARDNER DUFFETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS,PT

Contact information

Practice address
55 HARRIS RD, NASHUA, NH 03062-2145
(603) 888-1573
(603) 897-0514
Mailing address
67 BOULDER DR, LONDONDERRY, NH 03053-3789
(603) 437-3563

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
15760
MA
225100000X
Physical Therapist
Primary
2674
NH
225100000X
Physical Therapist
PT011311L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0334065
MA
01
15760
PHYS THERAPY LICENSE
MA
01
2674
PHYS THERAPY LICENSE
NH
01
PT011311L
PHYS THERAPY LICENSE
PA
Enumeration date
08/12/2006
Last updated
07/09/2007
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