Healthcare Provider Details

I. General information

NPI: 1740205764
Provider Name (Legal Business Name): BOW PHYSICAL THERAPY & SPINE CENTER LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SOUTH ST
BOW NH
03304-3416
US

IV. Provider business mailing address

501 SOUTH ST
BOW NH
03304-3416
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-5883
  • Fax: 603-224-6042
Mailing address:
  • Phone: 603-224-5883
  • Fax: 603-224-6042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LAWRANCE W MCAFEE
Title or Position: CFO
Credential:
Phone: 713-297-7000