| Organization Name: | COPPOLA PHYSICAL THERAPY AND FITNESS GYM LLC |
| NPI Number: | 1346481561 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN LAWRENCE GORDON (CO-OWNER, PTA) |
| Mailing Address: | 143 Raymond Rd Unit 8 Candia |
| State: | NH US |
| Postal Code: | 030342133 |
| Phone Number: | 6034833355 |
| Fax Number: | |
| NPI Enumeration Date: | 03/18/2009 |
| NPI Last Update Date: | 06/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 0740 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |