Healthcare Provider Details

I. General information

NPI: 1144692336
Provider Name (Legal Business Name): BIRCHWOOD THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 OLD DUBLIN RD
PETERBOROUGH NH
03458-1334
US

IV. Provider business mailing address

86 SHADY LN
HANCOCK NH
03449-5303
US

V. Phone/Fax

Practice location:
  • Phone: 603-769-1852
  • Fax:
Mailing address:
  • Phone: 603-769-1852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2316
License Number StateNH

VIII. Authorized Official

Name: COLLEEN O'CONNELL
Title or Position: OWNER & OCCUPATIONAL THERAPIST
Credential: MS OTR/L
Phone: 603-769-1852