Provider Demographics
NPI:1811414865
Name:YORK, CAMERON (DPT)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:YORK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 HANOVER ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-5401
Mailing Address - Country:US
Mailing Address - Phone:603-625-1864
Mailing Address - Fax:603-668-7181
Practice Address - Street 1:835 HANOVER ST STE 102
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5401
Practice Address - Country:US
Practice Address - Phone:603-625-1864
Practice Address - Fax:603-668-7181
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
NH4950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO840609239OtherWORK COMP
NH4950OtherPT LICENSE