Individual
C. ANTHONY BOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
237 ROUTE 108, SUITE 101, SOMERSWORTH, NH 03878-1517
(603) 749-6686
(603) 750-3174
Mailing address
200 ROUTE 108, SUITE 3, SOMERSWORTH, NH 03878-1119
(603) 742-7492
(603) 742-6762
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
142
NH
225100000X
Physical Therapist
1577
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08Y009940NH01
ANTHEM
NV
05
—
30394032
—
NH
Enumeration date
01/18/2007
Last updated
07/08/2007
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