Provider Demographics
NPI:1609016922
Name:LAYNE, BETHANY LYNNE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LYNNE
Last Name:LAYNE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:BETHANY
Other - Middle Name:LYNNE
Other - Last Name:DOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 WHITE OAK LANE
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038
Mailing Address - Country:US
Mailing Address - Phone:603-247-7554
Mailing Address - Fax:
Practice Address - Street 1:8 WHITE OAK LANE
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038
Practice Address - Country:US
Practice Address - Phone:603-247-7554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3130225100000X
MA16965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist