Healthcare Provider Details

I. General information

NPI: 1356624050
Provider Name (Legal Business Name): NORTH SHORE MYOFASCIAL PHYSICAL THERAPY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 SINCLAIR RD
NORTH HAVERHILL NH
03774-5963
US

IV. Provider business mailing address

85 SINCLAIR RD
NORTH HAVERHILL NH
03774-5963
US

V. Phone/Fax

Practice location:
  • Phone: 516-220-8835
  • Fax: 631-996-2958
Mailing address:
  • Phone: 603-787-9000
  • Fax: 603-787-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNH

VIII. Authorized Official

Name: MARIE LOUISE FRANCIS
Title or Position: PRESIDENT
Credential: PT
Phone: 603-787-9000