Healthcare Provider Details

I. General information

NPI: 1124063284
Provider Name (Legal Business Name): ROCHESTER PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 HIGH ST
SOMERSWORTH NH
03878-1411
US

IV. Provider business mailing address

388 HIGH ST
SOMERSWORTH NH
03878-1411
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-6626
  • Fax: 603-692-4766
Mailing address:
  • Phone: 603-692-6626
  • Fax: 603-692-4766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK J O'DONNELL
Title or Position: MEMBER
Credential: P.T.
Phone: 603-692-6626