Organization
JOHNELMS LLC
Active
Other names
CHOICE PHYSICAL THERAPY OF PLYMOUTH
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J FORTUNATO (VP OF FINANCE)
(860) 434-9398
Entity
Organization
Contact information
Practice address
790 LAKE ST, BRISTOL, NH 03222-4548
(603) 744-0275
(603) 744-9378
Mailing address
790 LAKE ST, BRISTOL, NH 03222-4548
(603) 744-0275
(603) 744-9378
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHOI59439
VT BLUE CROSS
VT
01
—
DD2778
RAILROAD MEDICARE
—
Enumeration date
06/18/2006
Last updated
02/14/2011
Update your record
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