Individual
DWAYNE OOTHOUDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
406 COURT ST, LACONIA, NH 03246-3600
(603) 524-0466
Mailing address
4 PEABODY ST, TILTON, NH 03276-5407
(603) 729-0056
(603) 729-0069
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0519
NH
225X00000X
Occupational Therapist
Primary
2551
NH
Other
Enumeration date
07/13/2015
Last updated
04/27/2016
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