Provider Demographics
NPI:1649693425
Name:G&S PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Entity type:Organization
Organization Name:G&S PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-969-6945
Mailing Address - Street 1:25 RIVERSIDE FARM DR
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:NH
Mailing Address - Zip Code:03861-6216
Mailing Address - Country:US
Mailing Address - Phone:603-659-6747
Mailing Address - Fax:
Practice Address - Street 1:25 RIVERSIDE FARM DR
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:NH
Practice Address - Zip Code:03861-6216
Practice Address - Country:US
Practice Address - Phone:603-659-6747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty