Organization
FALL MOUNTAIN PHYSICAL THERAPY AND ATHLETIC TRAINING, PLLC
Active
Other names
FMPTAT
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA N YOUNG MPT, ATC (OWNER, PT, ATC)
(603) 835-7828
Entity
Organization
Contact information
Practice address
122 NH ROUTE 12A, LANGDON, NH 03602-8221
(603) 835-7828
(603) 835-7827
Mailing address
PO BOX 57, ALSTEAD, NH 03602-0057
(603) 835-7828
(603) 835-7827
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2994
NH
2255A2300X
Athletic Trainer
0036
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08Y007675NH03
ANTHEM BCBS
NH
05
—
30394477
—
NH
01
—
6007380
MVP
NH
01
—
AA65774
HARVARD PILGRIM
NH
01
—
DF1145
RAILROAD MEDICARE
NH
Enumeration date
10/16/2006
Last updated
11/29/2007
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