Provider Demographics
NPI:1578782603
Name:ACE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ACE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:COPPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-228-7500
Mailing Address - Street 1:171 PLEASANT ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2547
Mailing Address - Country:US
Mailing Address - Phone:603-228-7500
Mailing Address - Fax:603-228-3503
Practice Address - Street 1:171 PLEASANT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2547
Practice Address - Country:US
Practice Address - Phone:603-228-7500
Practice Address - Fax:603-228-3503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2164174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH7052413OtherAETNA PPO
NH0140699OtherCIGNA
NH30393244Medicaid
NHAA22614OtherHARVARD PILGRIM
NH0805655Y0NH02OtherBLUECROSS GROUP ID
3709821OtherAETNA HMO
NH685494OtherUNITED HEALTH CARE
3709821OtherAETNA HMO
NHUX5133Medicare Oscar/Certification