Provider Demographics
NPI:1083829030
Name:GREENWOOD THERAPY SERVICES
Entity Type:Organization
Organization Name:GREENWOOD THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-401-3830
Mailing Address - Street 1:18 ANSEL ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-4550
Mailing Address - Country:US
Mailing Address - Phone:603-401-3830
Mailing Address - Fax:603-458-2121
Practice Address - Street 1:18 ANSEL ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-4550
Practice Address - Country:US
Practice Address - Phone:603-401-3830
Practice Address - Fax:603-458-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26222251P0200X
MA115942251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty