Provider Demographics
NPI:1346513934
Name:FOX, MICHELE (PT, DPT, MS)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 INDIAN ROCK RD #5
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087
Mailing Address - Country:US
Mailing Address - Phone:603-890-8541
Mailing Address - Fax:
Practice Address - Street 1:32 INDIAN ROCK RD #5
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087
Practice Address - Country:US
Practice Address - Phone:603-890-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA100592251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic