| Organization Name: | INDEPENDENCE THERAPY ASSOCIATES LLC |
| NPI Number: | 1134382096 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KERRY ANN RAYMOND (CO-OWNER) |
| Mailing Address: | 32 Indian Rock Rd Unit 4 Windham |
| State: | NH US |
| Postal Code: | 030871608 |
| Phone Number: | 6039524560 |
| Fax Number: | 6039524561 |
| NPI Enumeration Date: | 07/09/2008 |
| NPI Last Update Date: | 03/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | 0746 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |