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General NPI Number Information
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NPI Number | 1629361175
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Entity Type | Organization
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Legal Business Name | GENESIS REHAB SERVICES
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 05/17/2011
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Provider Practice Location Address
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Address Line | 91 COUNTRY VILLAGE RD
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City | LANCASTER
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State | NH
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Zip | 03584-3142
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Country | US
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Telephone | 603-788-2096
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Fax |
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Provider Business Mailing Address
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Address Line | 90 JIMTOWN RD
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City | GORHAM
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State | NH
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Zip | 03581-4826
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Country | US
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Telephone | 603-703-7308
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. ELIZABETH WELCH
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Credential | PT, ATC
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Telephone | 603-788-2096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 3536
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License Number State | NH
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