Individual
MR. CARL WADE PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
307 PLAZA DR, DOVER, NH 03820-2455
(603) 750-2900
Mailing address
27 LINCOLN DR, NOTTINGHAM, NH 03290-6024
(603) 942-5025
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0503
NH
Other
Enumeration date
05/26/2007
Last updated
07/08/2007
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