Provider Demographics
NPI:1497841738
Name:HEARN, JEAN O (PT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:O
Last Name:HEARN
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 1:393 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6105
Mailing Address - Country:US
Mailing Address - Phone:603-879-0672
Mailing Address - Fax:
Practice Address - Street 1:42 DOVER POINT RD UNIT M
Practice Address - Street 2:DOVER POINT OFFICE PARK
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-4669
Practice Address - Country:US
Practice Address - Phone:603-740-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0750225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist