Provider Demographics
NPI:1437600129
Name:OAK PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:OAK PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-412-6144
Mailing Address - Street 1:382 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-5046
Mailing Address - Country:US
Mailing Address - Phone:603-821-9194
Mailing Address - Fax:
Practice Address - Street 1:382 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-5046
Practice Address - Country:US
Practice Address - Phone:603-821-9194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH750611261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy