| Organization Name: | SCACCIA PHYSICAL THERAPY & SPORTS CONDITIONING, LLC |
| NPI Number: | 1174796056 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT M SCACCIA (PRESIDENT) |
| Mailing Address: | 60 Rockingham Rd Unit 2 Windham |
| State: | NH US |
| Postal Code: | 030871347 |
| Phone Number: | 6038908541 |
| Fax Number: | 6038908736 |
| NPI Enumeration Date: | 04/10/2008 |
| NPI Last Update Date: | 04/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |