Provider Demographics
NPI:1477681062
Name:CLAPP, ANTOINETTE (PT)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:CLAPP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02364-1101
Mailing Address - Country:US
Mailing Address - Phone:781-585-5312
Mailing Address - Fax:
Practice Address - Street 1:208 BROADWAY
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2382
Practice Address - Country:US
Practice Address - Phone:781-829-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3559-AH225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY69727Medicare ID - Type UnspecifiedPHYSICAL THERAPY