# BAKER VALLEY SPORTS & PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285722348
- **Authorized official:** MR. MICHAEL P HOGAN PT, MPT (CLINIC DIRECTOR)
- **Authorized official phone:** (603) 536-7777

## Contact information

- **Practice address:** 612 TENNEY MOUNTAIN HWY, UNIT 3, TENNEY MOUNTAIN PLAZA, PLYMOUTH, NH 03264-3155
- **Practice address phone:** (603) 536-7777
- **Practice address fax:** (603) 536-7787
- **Mailing address:** 612 TENNEY MOUNTAIN HWY, UNIT 3, TENNEY MOUNTAIN PLAZA, PLYMOUTH, NH 03264-3155
- **Mailing address phone:** (603) 536-7777
- **Mailing address fax:** (603) 536-7787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | 3075 | NH | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 08/22/2020