Provider Demographics
NPI:1285960534
Name:HUTCHISON-DAME, LEAH A (PT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:A
Last Name:HUTCHISON-DAME
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 1:60 QUAKER HWY
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-1628
Mailing Address - Country:US
Mailing Address - Phone:508-278-7810
Mailing Address - Fax:508-278-7855
Practice Address - Street 1:60 QUAKER HWY
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569-1628
Practice Address - Country:US
Practice Address - Phone:508-278-7810
Practice Address - Fax:508-278-7855
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA225760Medicare UPIN