Organization
LIGHTHOUSE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GLENN BURCHUK PT (OWNER/PHYSICAL THERAPIST)
(603) 431-0277
Entity
Organization
Contact information
Practice address
1 CATE ST STE 110, PORTSMOUTH, NH 03801-7107
(603) 431-0277
(603) 422-8849
Mailing address
1 CATE ST STE 110, PORTSMOUTH, NH 03801-7107
(603) 431-0277
(603) 422-8849
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1271
NH
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0803055Y0NH01
BCBS - DAVE BURCHUK
NH
01
—
0804210Y0NH04
BCBS
NH
01
—
0806114Y0NH01
BCBS - SARAH TROOST
NH
01
—
08Y003493NH01
BCBS
NH
01
—
08Y011802NH02
BCBS
NH
Enumeration date
02/01/2006
Last updated
05/22/2019
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