Individual
SAMUEL BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
144 CANAL ST, NASHUA, NH 03064-2886
(603) 459-2725
(603) 459-2783
Mailing address
144 CANAL ST, NASHUA, NH 03064-2886
(603) 459-2725
(603) 459-2783
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2587
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3071948
—
NH
Enumeration date
08/23/2016
Last updated
08/23/2016
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