Provider Demographics
NPI:1558578799
Name:HEWARD, ELIZABETH E (MPT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:E
Last Name:HEWARD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 NORTHEY ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3904
Mailing Address - Country:US
Mailing Address - Phone:908-500-4380
Mailing Address - Fax:
Practice Address - Street 1:110 HAVERHILL RD
Practice Address - Street 2:#401
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2123
Practice Address - Country:US
Practice Address - Phone:908-500-4380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17119225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist