Provider Demographics
NPI:1821322272
Name:ELM CITY PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ELM CITY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-352-8000
Mailing Address - Street 1:103 ROXBURY STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-8801
Mailing Address - Country:US
Mailing Address - Phone:603-352-8000
Mailing Address - Fax:603-352-8001
Practice Address - Street 1:103 ROXBURY ST
Practice Address - Street 2:SUITE 201
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-8801
Practice Address - Country:US
Practice Address - Phone:603-352-8000
Practice Address - Fax:603-352-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2881225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty