Provider Demographics
NPI:1033497516
Name:ATLANTIC PHYSICAL THERAPY & WEIGHTLOSS CENTER
Entity Type:Organization
Organization Name:ATLANTIC PHYSICAL THERAPY & WEIGHTLOSS CENTER
Other - Org Name:ATLANTIC PHYSICAL THERAPY & WEIGHTLOSS CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-422-3387
Mailing Address - Street 1:100 ISLINGTON STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NEW HAMPSHIRE
Mailing Address - Zip Code:03801
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 ISLINGTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4263
Practice Address - Country:US
Practice Address - Phone:603-436-9229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty