Provider Demographics
NPI:1932342045
Name:DURKIS, SUNDRA LEE (PT)
Entity Type:Individual
Prefix:MS
First Name:SUNDRA
Middle Name:LEE
Last Name:DURKIS
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 1:26 LITTLE POND RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3007
Mailing Address - Country:US
Mailing Address - Phone:603-224-0716
Mailing Address - Fax:
Practice Address - Street 1:33 CHRISTIAN AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-6128
Practice Address - Country:US
Practice Address - Phone:603-224-5363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist