Provider Demographics
NPI:1376688739
Name:THURBER, PETER JOSHUA (MED, ATC, NHLAT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:JOSHUA
Last Name:THURBER
Suffix:
Gender:M
Credentials:MED, ATC, NHLAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:NH
Mailing Address - Zip Code:03741-7216
Mailing Address - Country:US
Mailing Address - Phone:603-523-9832
Mailing Address - Fax:
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NH
Practice Address - Zip Code:03257-7818
Practice Address - Country:US
Practice Address - Phone:603-526-3064
Practice Address - Fax:603-526-3875
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer