Provider Demographics
NPI:1275890915
Name:STORCH, DARA FRANCES (DPT)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:FRANCES
Last Name:STORCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:FRANCES
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:422 CENTRAL AVE # 193
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3411
Mailing Address - Country:US
Mailing Address - Phone:603-609-8830
Mailing Address - Fax:
Practice Address - Street 1:422 CENTRAL AVE
Practice Address - Street 2:#193 (MAILING ADDRESS ONLY)
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3411
Practice Address - Country:US
Practice Address - Phone:603-609-8830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT4382225100000X
NHNH3699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPT4382OtherPHYSICAL THERAPY LICENSE
NHNH3699OtherPHYSICAL THERAPY LICENSE