Provider Demographics
NPI:1669460150
Name:HUNT, JOHN R (CCC SLP)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:HUNT
Suffix:
Gender:M
Credentials:CCC SLP
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Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:INNOVATIVE PHYSICIAN SERVICES LLC
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-0391
Mailing Address - Country:US
Mailing Address - Phone:508-595-0531
Mailing Address - Fax:508-829-5367
Practice Address - Street 1:592 CENTER ST
Practice Address - Street 2:INNOVATIVE PHYSICIAN SERVICES LLC
Practice Address - City:LUDLOW
Practice Address - State:MA
Practice Address - Zip Code:01056-1461
Practice Address - Country:US
Practice Address - Phone:413-547-0012
Practice Address - Fax:413-547-0034
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2820235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist