Provider Demographics
NPI:1457543050
Name:CARLISLE PLACE PHYSICAL THERAPY AND WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:CARLISLE PLACE PHYSICAL THERAPY AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-586-4100
Mailing Address - Street 1:55 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NH
Mailing Address - Zip Code:03584-3027
Mailing Address - Country:US
Mailing Address - Phone:603-586-6046
Mailing Address - Fax:603-586-0084
Practice Address - Street 1:55 MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NH
Practice Address - Zip Code:03584-3027
Practice Address - Country:US
Practice Address - Phone:603-586-6046
Practice Address - Fax:603-586-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty