Provider Demographics
NPI:1831599646
Name:BODY AND MIND PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:BODY AND MIND PHYSICAL THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:VOSE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MS, CIDN
Authorized Official - Phone:603-458-7988
Mailing Address - Street 1:127 ROCKINGHAM RD STE 204
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1360
Mailing Address - Country:US
Mailing Address - Phone:603-458-7988
Mailing Address - Fax:603-513-2833
Practice Address - Street 1:127 ROCKINGHAM RD STE 204
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1360
Practice Address - Country:US
Practice Address - Phone:603-458-7988
Practice Address - Fax:603-513-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208100000X
NH33822251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHT100192195Medicare UPIN