Provider Demographics
NPI:1770813438
Name:UNITED PHYSICAL THERAPY AND REHABILITATION
Entity type:Organization
Organization Name:UNITED PHYSICAL THERAPY AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HUMPHREY
Authorized Official - Last Name:MERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, PT, DC
Authorized Official - Phone:603-641-4800
Mailing Address - Street 1:93 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-5749
Mailing Address - Country:US
Mailing Address - Phone:603-641-4800
Mailing Address - Fax:603-622-3199
Practice Address - Street 1:93 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-5749
Practice Address - Country:US
Practice Address - Phone:603-641-4800
Practice Address - Fax:603-622-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty