| Organization Name: | LEGACY PHYSICAL THERAPY LLC |
| NPI Number: | 1033499314 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA BERUBE (PHYSICAL THERAPIST/OWNER/DIRECTOR) |
| Mailing Address: | 110 Haverhill Rd Suite 292 Amesbury |
| State: | MA US |
| Postal Code: | 019132123 |
| Phone Number: | 4138867825 |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2011 |
| NPI Last Update Date: | 08/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 17059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |