Provider Demographics
NPI:1699386920
Name:NEW HAMPSHIRE PHYSICAL THERAPY WELLNESS
Entity Type:Organization
Organization Name:NEW HAMPSHIRE PHYSICAL THERAPY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-998-9092
Mailing Address - Street 1:636 WINONA RD
Mailing Address - Street 2:
Mailing Address - City:CENTER HARBOR
Mailing Address - State:NH
Mailing Address - Zip Code:03226-3128
Mailing Address - Country:US
Mailing Address - Phone:603-998-9092
Mailing Address - Fax:
Practice Address - Street 1:636 WINONA RD
Practice Address - Street 2:
Practice Address - City:CENTER HARBOR
Practice Address - State:NH
Practice Address - Zip Code:03226-3128
Practice Address - Country:US
Practice Address - Phone:603-998-9092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty