Organization
PEDS 2 POPS OT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE OOTHOUDT OTR/L (OCCUPATIONAL THERAPIST)
(603) 729-0056
Entity
Organization
Contact information
Practice address
4 PEABODY ST, TILTON, NH 03276-5407
(603) 729-0056
(603) 729-0069
Mailing address
4 PEABODY ST, TILTON, NH 03276-5407
(603) 729-0056
(603) 729-0069
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2551
NH
Other
Enumeration date
04/27/2016
Last updated
06/06/2016
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