Individual
MR. DOUGLAS JOHN DENNISON
Active
Individual
MR. DOUGLAS JOHN DENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017594
PA
2251G0304X
Geriatric Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073637
AETNA HMO
—
01
—
11516549
CAQH
—
01
—
2002374
KEYSTONE
—
01
—
2451219000
INDEPENDENCE BLUE CROSS
—
01
—
268316
HEALTH ASSURANCE
—
01
—
50054393
CAPITAL BLUE CROSS
—
01
—
7146701
AETNA PPO
—
01
—
819644
FIRST PRIORITY HEALTH
—
01
—
DE1769215
HIGHMARK BLUE SHIELD
—
Enumeration date
09/29/2005
Last updated
04/08/2010
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