Provider Demographics
NPI:1821588328
Name:NORTH COUNTRY PHYSICAL THERAPY & WELLNESS
Entity Type:Organization
Organization Name:NORTH COUNTRY PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:603-369-0228
Mailing Address - Street 1:19 BACK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:NH
Mailing Address - Zip Code:03592-5402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 BACK LAKE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:NH
Practice Address - Zip Code:03592-5402
Practice Address - Country:US
Practice Address - Phone:603-369-0228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy