Healthcare Provider Details
I. General information
NPI: 1811355373
Provider Name (Legal Business Name): FOX REHAB-NH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2016
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 CONSTITUTION DR 1ST FLOOR SUITE 144
BEDFORD NH
03110-6042
US
IV. Provider business mailing address
7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US
V. Phone/Fax
- Phone: 877-407-3422
- Fax: 877-407-4329
- Phone: 877-407-3422
- Fax: 877-407-4329
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | NH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | NH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | NH |
VIII. Authorized Official
Name:
NEIL
WEISSHAAR
Title or Position: VP OF INFORMATION SYSTEMS
Credential:
Phone: 877-407-3422