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General NPI Number Information
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NPI Number | 1114145794
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR BODIES IN BALANCE, LLC
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Dates
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Enumeration Date | 04/21/2007
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 1 GREENLEAF WOODS DR SUITE 101
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City | PORTSMOUTH
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State | NH
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Zip | 03801-5437
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Country | US
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Telephone | 603-319-8334
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Fax |
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Provider Business Mailing Address
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Address Line | 1 GREENLEAF WOODS DR SUITE 101
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City | PORTSMOUTH
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State | NH
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Zip | 03801-5437
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Country | US
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Telephone | 603-319-8334
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MARY ELIZABETH MARCINKOWSKI
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Credential | PT
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Telephone | 603-319-8334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 0714
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 0714
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0714
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License Number State | NH
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