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General NPI Number Information
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NPI Number | 1063810455
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Entity Type | Organization
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Legal Business Name | SLOPESIDE PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/17/2014
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Last Update Date | 06/05/2015
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Provider Practice Location Address
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Address Line | 1 SKIMOBILE RD
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City | NORTH CONWAY
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State | NH
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Zip | 03860-5364
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Country | US
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Telephone | 603-662-2884
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2
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City | CENTER CONWAY
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State | NH
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Zip | 03813-0002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW GEARY
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Credential | DPT
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Telephone | 603-662-2884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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