Provider Demographics
NPI:1598987364
Name:DANA L. KENNEDY
Entity Type:Organization
Organization Name:DANA L. KENNEDY
Other - Org Name:QUALITY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-641-6603
Mailing Address - Street 1:908 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-5422
Mailing Address - Country:US
Mailing Address - Phone:603-641-6603
Mailing Address - Fax:603-644-3001
Practice Address - Street 1:908 HANOVER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-5422
Practice Address - Country:US
Practice Address - Phone:603-641-6603
Practice Address - Fax:603-644-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH2178Medicare ID - Type Unspecified