Provider Demographics
NPI:1124618087
Name:TRUE NORTH PELVIC PT LLC
Entity type:Organization
Organization Name:TRUE NORTH PELVIC PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:WEBSTER
Authorized Official - Last Name:HEALY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-755-5678
Mailing Address - Street 1:17 MEADOW VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CORNISH
Mailing Address - State:NH
Mailing Address - Zip Code:03745-4647
Mailing Address - Country:US
Mailing Address - Phone:802-755-5678
Mailing Address - Fax:888-853-6970
Practice Address - Street 1:20 W PARK ST STE 423
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-6309
Practice Address - Country:US
Practice Address - Phone:802-755-5678
Practice Address - Fax:888-853-6970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-24
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty