Provider Demographics
NPI:1285934380
Name:LIVING WELL PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:LIVING WELL PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:603-401-3044
Mailing Address - Street 1:184 RAYMOND RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03036-4127
Mailing Address - Country:US
Mailing Address - Phone:603-887-7800
Mailing Address - Fax:603-887-7801
Practice Address - Street 1:184 RAYMOND RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NH
Practice Address - Zip Code:03036-4127
Practice Address - Country:US
Practice Address - Phone:603-887-7800
Practice Address - Fax:603-887-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-24
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2775261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy