# COPPOLA PHYSICAL THERAPY AND FITNESS GYM LLC

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

## Provider details

- **NPI number:** 1346481561
- **Authorized official:** STEVEN LAWRENCE GORDON (CO-OWNER, PTA)
- **Authorized official phone:** (603) 315-9552

## Contact information

- **Practice address:** 143 RAYMOND RD UNIT 8, CANDIA, NH 03034-2133
- **Practice address phone:** (603) 483-3355
- **Mailing address:** 143 RAYMOND RD UNIT 8, CANDIA, NH 03034-2133
- **Mailing address phone:** (603) 483-3355
- **Mailing address fax:** (603) 483-3357

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | 0740 | NH | — |
| 261QP2000X | Physical Therapy Clinic/Center | 2164 | NH | Yes |

## Other

- **Enumeration date:** 03/18/2009
- **Last updated:** 06/02/2014