Provider Demographics
NPI:1134970783
Name:SANTOS PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:SANTOS PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:401-935-8925
Mailing Address - Street 1:742 JOCKEY HILL RD
Mailing Address - Street 2:
Mailing Address - City:LANDAFF
Mailing Address - State:NH
Mailing Address - Zip Code:03585-5312
Mailing Address - Country:US
Mailing Address - Phone:401-935-8925
Mailing Address - Fax:
Practice Address - Street 1:5 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:NH
Practice Address - Zip Code:03585-6210
Practice Address - Country:US
Practice Address - Phone:401-935-8925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty