Healthcare Provider Details

I. General information

NPI: 1407291487
Provider Name (Legal Business Name): WELLBRIDGE PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 CONSTITUTION DR
BEDFORD NH
03110-6096
US

IV. Provider business mailing address

48 CONSTITUTION DR
BEDFORD NH
03110-6096
US

V. Phone/Fax

Practice location:
  • Phone: 781-354-5196
  • Fax:
Mailing address:
  • Phone: 781-354-5196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. VLADIMIR BENJAMIN SHURSKY
Title or Position: PRESIDENT/PHYSICAL THERAPIST
Credential: DPT
Phone: 603-488-5808