Healthcare Provider Details

I. General information

NPI: 1720161581
Provider Name (Legal Business Name): INTEGRATED REHABILITATION SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 ROUTE 16 HODSDON FARM BUILDING
OSSIPEE NH
03864
US

IV. Provider business mailing address

PO BOX 297 1230 RTE. 16
OSSIPEE NH
03864-0297
US

V. Phone/Fax

Practice location:
  • Phone: 603-539-5351
  • Fax: 603-539-3531
Mailing address:
  • Phone: 603-539-5351
  • Fax: 603-539-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CORNELIUS J. DONNELLY
Title or Position: OWNER
Credential: PT
Phone: 603-539-5351