Provider Demographics
NPI:1811964851
Name:CLUTE, LAUREL L (PT)
Entity type:Individual
Prefix:PROF
First Name:LAUREL
Middle Name:L
Last Name:CLUTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ROUTE 10
Mailing Address - Street 2:
Mailing Address - City:EAST LEMPSTER
Mailing Address - State:NH
Mailing Address - Zip Code:03605
Mailing Address - Country:US
Mailing Address - Phone:603-863-9049
Mailing Address - Fax:
Practice Address - Street 1:1 COLLEGE DR
Practice Address - Street 2:NEW HAMPSHIRE COMMUNITY TECHNICAL COLLEGE
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-9707
Practice Address - Country:US
Practice Address - Phone:603-542-7744
Practice Address - Fax:603-543-1844
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist