Provider Demographics
NPI:1861249054
Name:INTEGRATED PHYSICAL THERAPY & WELLNESS, LLC
Entity type:Organization
Organization Name:INTEGRATED PHYSICAL THERAPY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIANNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GROLEAU
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-998-4530
Mailing Address - Street 1:29 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-6419
Mailing Address - Country:US
Mailing Address - Phone:603-998-4530
Mailing Address - Fax:
Practice Address - Street 1:29 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-6419
Practice Address - Country:US
Practice Address - Phone:603-998-4530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy