MEDICARE: RIDGELINE PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1144910514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDGELINE PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	58 LAFAYETTE RD BAY 8
Second Line	:
City	:	NORTH HAMPTON
State	:	NH
Zip	:	03862-2463
Country	:	US
Telephone Number	:	120-777-6562
Fax Number	:

Provider Business Practice Location Address
First Line	:	58 LAFAYETTE RD BAY 8
Second Line	:
City	:	NORTH HAMPTON
State	:	NH
Zip	:	03862-2463
Country	:	US
Telephone Number	:	120-777-6562
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MORGAN PILLSBURY
Credential	:	PT, DPT
Telephone Number	:	207-776-5628

Provider Enumeration Date	:	05/10/2023
Last Update Date	:	05/31/2023

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