Provider Demographics
NPI:1245354471
Name:HOUGHTON, TODD A (PT)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:HOUGHTON
Suffix:
Gender:M
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:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703
Mailing Address - Country:US
Mailing Address - Phone:508-223-2300
Mailing Address - Fax:508-223-2340
Practice Address - Street 1:80 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2335
Practice Address - Country:US
Practice Address - Phone:508-223-2300
Practice Address - Fax:508-223-2340
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
610889OtherTUFTS
0000026914OtherRHODE ISLAND BLUE CROSS B
020683197OtherUNITED HEALTHCARE
MA9725300Medicaid
Y61358OtherMASSACHUSETTS BLUE CROSS
92826OtherFALLON
AA16980OtherHARVARD PILGRIM HEALTHCAR
MAPT0202Medicare ID - Type Unspecified