Provider Demographics
NPI:1972682375
Name:BODYWISE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:BODYWISE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DORER
Authorized Official - Last Name:POPLASKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-548-6116
Mailing Address - Street 1:285 CALEF HWY UNIT 11
Mailing Address - Street 2:
Mailing Address - City:EPPING
Mailing Address - State:NH
Mailing Address - Zip Code:03042-2367
Mailing Address - Country:US
Mailing Address - Phone:603-679-8100
Mailing Address - Fax:603-679-8177
Practice Address - Street 1:285 CALEF HWY UNIT 11
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2367
Practice Address - Country:US
Practice Address - Phone:603-679-8100
Practice Address - Fax:603-679-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2970225100000X
NH2957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
11217857OtherCAQH
11350141OtherCAQH