Provider Demographics
NPI:1780191601
Name:CORNERSTONE PT ASSOCIATES,LLC
Entity type:Organization
Organization Name:CORNERSTONE PT ASSOCIATES,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-895-6860
Mailing Address - Street 1:64 FREETOWN RD STE 3
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:NH
Mailing Address - Zip Code:03077-2356
Mailing Address - Country:US
Mailing Address - Phone:603-895-6860
Mailing Address - Fax:603-895-6861
Practice Address - Street 1:64 FREETOWN RD STE 3
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077-2356
Practice Address - Country:US
Practice Address - Phone:603-895-6860
Practice Address - Fax:603-895-6861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-30
Last Update Date:2017-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH06452251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH12149135OtherCAQH
1386832533OtherINDIVIDUAL NPI NUMBER