Healthcare Provider Details

I. General information

NPI: 1982988192
Provider Name (Legal Business Name): COPPOLA PHYSICAL THERAPY FERRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 FERRY ST
CONCORD NH
03301-5022
US

IV. Provider business mailing address

10 FERRY ST
CONCORD NH
03301-5022
US

V. Phone/Fax

Practice location:
  • Phone: 603-236-7847
  • Fax: 603-856-7694
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN M COPPOLA
Title or Position: PRESIDENT
Credential: PT DPT
Phone: 603-483-3355