Provider Demographics
NPI:1508897497
Name:CAVENDER, JOAN A (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:A
Last Name:CAVENDER
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 1:181 HALFMOON POND RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03280-3129
Mailing Address - Country:US
Mailing Address - Phone:603-464-4261
Mailing Address - Fax:603-464-5461
Practice Address - Street 1:190 WEST MAIN ST.
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:NH
Practice Address - Zip Code:03244
Practice Address - Country:US
Practice Address - Phone:603-464-4261
Practice Address - Fax:603-464-5461
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1435225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist