Timothy Gary White Jr., PTA

Individual provider Active NPI Physical Therapy Assistant · Franconia, NH

NPI 1659404689 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1659404689
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
559 (NH)
Practice address
93 Main St
Franconia, NH 03580-4801
Phone
(603) 823-5502
Fax
(603) 823-7138
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
559NHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carlisle Place Physical Therapy and Wellness Center, LLC Past
since Jun 1, 2007
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 559 NH Yes

Addresses

Primary practice location

93 Main St
Franconia, NH 03580-4801

Mailing address

72 Lancaster Rd
Whitefield, NH 03598-3094
Phone (603) 837-2802

Other providers in Franconia, NH

All providers in Franconia, NH · Physical Therapy Assistant in New Hampshire

Sources for this page

Verify at the official NPI Registry.