Provider Demographics
NPI:1679698088
Name:ATHERTON, RAYMOND ROBERT (OTR)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:ROBERT
Last Name:ATHERTON
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GREEN HILL RD
Mailing Address - Street 2:
Mailing Address - City:GILL
Mailing Address - State:MA
Mailing Address - Zip Code:01354-9621
Mailing Address - Country:US
Mailing Address - Phone:413-265-4665
Mailing Address - Fax:
Practice Address - Street 1:677 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1702
Practice Address - Country:US
Practice Address - Phone:603-354-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1804225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist