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General NPI Number Information
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NPI Number | 1871003954
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Entity Type | Organization
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Legal Business Name | LYMPHEDEMA REHAB, LLC
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 10/03/2017
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Provider Practice Location Address
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Address Line | 6 LOUDON RD STE 203
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City | CONCORD
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State | NH
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Zip | 03301-5321
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Country | US
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Telephone | 570-419-0933
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Fax |
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Provider Business Mailing Address
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Address Line | 98 ELM ST
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City | GOFFSTOWN
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State | NH
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Zip | 03045-1913
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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 | MEGAN MCLEAN
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Credential |
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Telephone | 570-419-0943
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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 | 3872
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License Number State | NH
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