Organization
COPPOLA PHYSICAL THERAPY AND FITNESS GYM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LAWRENCE GORDON (CO-OWNER, PTA)
(603) 315-9552
Entity
Organization
Contact information
Practice address
143 RAYMOND RD UNIT 8, CANDIA, NH 03034-2133
(603) 483-3355
Mailing address
143 RAYMOND RD UNIT 8, CANDIA, NH 03034-2133
(603) 483-3355
(603) 483-3357
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
0740
NH
261QP2000X
Physical Therapy Clinic/Center
Primary
2164
NH
Other
Enumeration date
03/18/2009
Last updated
06/02/2014
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