Provider Demographics
NPI:1184064024
Name:PREMIER PHYSICAL THERAPY SERVICES OF SOUTHERN NEW HAMPSHIRE
Entity type:Organization
Organization Name:PREMIER PHYSICAL THERAPY SERVICES OF SOUTHERN NEW HAMPSHIRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGIC
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:603-490-3706
Mailing Address - Street 1:137 MORNING GLORY DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5945
Mailing Address - Country:US
Mailing Address - Phone:603-490-3706
Mailing Address - Fax:
Practice Address - Street 1:25 NASHUA RD
Practice Address - Street 2:SUITE F-3
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3446
Practice Address - Country:US
Practice Address - Phone:603-490-3706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3724261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy