Coppola Physical Therapy and Fitness Gym LLC

Organization Active NPI Physical Therapy Clinic/Center · Candia, NH

NPI 1346481561 · NPPES record last updated Jun 2, 2014

Key facts

NPI
1346481561
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
License
2164 (NH)
Legal business name
COPPOLA PHYSICAL THERAPY AND FITNESS GYM LLC
Practice address
143 Raymond Rd Unit 8
Candia, NH 03034-2133
Phone
(603) 483-3355
NPI assigned
Mar 18, 2009
Organization subpart
No

Authorized official

Name
Steven Lawrence Gordon NPI 1932287398
Title
Co-Owner, Pta
Phone
(603) 315-9552

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 42

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NH

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090810000044 NH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345393302 Receives reassigned benefits from 28 practitioners
Practice locations: Raymond, NH; Goffstown, NH; Derry, NH; Concord, NH; Candia, NH

National Provider Directory

Locations

143 Raymond Rd
Unit 8
Candia, NH 03034
Phone (603) 483-3355

81 Hall St
Ste 202
Concord, NH 03301
Phone (603) 228-7500

6 Old Fremont Road Ext
Ste 6
Raymond, NH 03077
Phone 6037957380305

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X
Physical Therapy Clinic/Center 261QP2000X 2164 NH Yes
Physical Therapy Clinic/Center 261QP2000X 0740 NH

Addresses

Primary practice location

143 Raymond Rd Unit 8
Candia, NH 03034-2133

Mailing address

143 Raymond Rd Unit 8
Candia, NH 03034-2133
Phone (603) 483-3355

Other providers in Candia, NH

All providers in Candia, NH · Physical Therapy Clinic/Center in New Hampshire

Sources for this page

Verify at the official NPI Registry.