Provider Demographics
NPI:1598756876
Name:SEACOAST PHYSICAL THERAPY SERVICES INC
Entity Type:Organization
Organization Name:SEACOAST PHYSICAL THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:603-749-3366
Mailing Address - Street 1:11 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2734
Mailing Address - Country:US
Mailing Address - Phone:603-749-3366
Mailing Address - Fax:603-742-4577
Practice Address - Street 1:11 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2734
Practice Address - Country:US
Practice Address - Phone:603-749-3366
Practice Address - Fax:603-742-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0234174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
64-00018OtherUNITED/METROHEALTH
NH65660200OtherBLUECROSS BLUE SHIELD
398557OtherFIRST HEALTH
78986OtherUS HEALTHCARE
774OtherCIGNA
NH80002706Medicaid
NH80002706Medicaid
NHRE6026Medicare ID - Type Unspecified