Provider Demographics
NPI:1104381219
Name:SUSTAINING SOLUTIONS PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:SUSTAINING SOLUTIONS PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LACEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:603-443-2629
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03748-0764
Mailing Address - Country:US
Mailing Address - Phone:603-306-1648
Mailing Address - Fax:603-410-0191
Practice Address - Street 1:6 ALFANO DR
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:NH
Practice Address - Zip Code:03748-3828
Practice Address - Country:US
Practice Address - Phone:033-061-6486
Practice Address - Fax:603-410-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty