Granite State Adaptive is a
Physical Therapist based in Mirror Lake, New Hampshire. Granite State Adaptive is licensed to practice in New Hampshire (license number 681) and their current practice location is
44 Mirror Lake Dr, Mirror Lake, New Hampshire. It can be reached at their office (for appointments etc.) via phone at
(603) 387-1167.
NPI number for Granite State Adaptive is 1114366887 and their current mailing address is Po Box 24, Mirror Lake, New Hampshire. Granite State Adaptive
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1114366887.
Healthcare Provider's Profile
| Full Name | Granite State Adaptive |
|---|
| Type | Facility |
|---|
| Speciality | Physical Therapist |
|---|
| Location | 44 Mirror Lake Dr, Mirror Lake, New Hampshire |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1114366887
- Provider Enumeration Date: 06/17/2013
- Last Update Date: 06/17/2013
Medical Identifiers
Medical identifiers for Granite State Adaptive such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114366887 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | 681 (New Hampshire) | Primary |
| 225700000X | Massage Therapist | 2924M (New Hampshire) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Granite State Adaptive is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Granite State Adaptive
Po Box 24,
Mirror Lake, NH 03853-0024
Ph: (603) 387-1167 | Granite State Adaptive
44 Mirror Lake Dr,
Mirror Lake, NH 03853-5953
Ph: (603) 387-1167 |
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