Provider Demographics
NPI:1497372585
Name:WHITE MOUNTAIN PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:WHITE MOUNTAIN PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KURZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:518-275-5650
Mailing Address - Street 1:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:MOULTONBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03254-0601
Mailing Address - Country:US
Mailing Address - Phone:603-273-1570
Mailing Address - Fax:
Practice Address - Street 1:1040 WHITTIER HWY
Practice Address - Street 2:UNIT 3
Practice Address - City:MOULTONBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03254
Practice Address - Country:US
Practice Address - Phone:603-273-1570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty