Provider Demographics
NPI:1487852703
Name:MCMAUGH, JENNIFER (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MCMAUGH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1145
Mailing Address - Street 2:
Mailing Address - City:CENTER HARBOR
Mailing Address - State:NH
Mailing Address - Zip Code:03226-1145
Mailing Address - Country:US
Mailing Address - Phone:603-253-9341
Mailing Address - Fax:
Practice Address - Street 1:186 WAUKEWAN ST
Practice Address - Street 2:
Practice Address - City:MEREDITH
Practice Address - State:NH
Practice Address - Zip Code:03253-6023
Practice Address - Country:US
Practice Address - Phone:603-279-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-08
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0843225200000X
NH3785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH225X00000XOtherPHYSICAL THERAPIST ASSIST
225X00000XOtherPHYSICAL THERAPIST