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General NPI Number Information
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NPI Number | 1578782603
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Entity Type | Organization
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Legal Business Name | ACE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 171 PLEASANT ST SUITE 101
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City | CONCORD
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State | NH
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Zip | 03301-2547
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Country | US
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Telephone | 603-228-7500
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Fax | 603-228-3503
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Provider Business Mailing Address
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Address Line | 171 PLEASANT ST SUITE 101
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City | CONCORD
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State | NH
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Zip | 03301-2547
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Country | US
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Telephone | 603-228-7500
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Fax | 603-228-3503
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR OWNER
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Name | STEVEN M COPPOLA
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Credential | PT
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Telephone | 603-228-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2164
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License Number State | NH
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