Provider Demographics
NPI:1598398406
Name:RENEW PHYSICAL THERAPY
Entity Type:Organization
Organization Name:RENEW PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:ARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLAMETA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:603-546-5140
Mailing Address - Street 1:450 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW IPSWICH
Mailing Address - State:NH
Mailing Address - Zip Code:03071-3630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 RIVER RD
Practice Address - Street 2:
Practice Address - City:NEW IPSWICH
Practice Address - State:NH
Practice Address - Zip Code:03071-3630
Practice Address - Country:US
Practice Address - Phone:603-546-5140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty