RENEGADE MOVEMENT AND PERFORMANCE, LLC (NPI# 1770100893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770100893 |
Entity Type | Organization |
Organization Name | RENEGADE MOVEMENT AND PERFORMANCE, LLC |
Practice Address |
200 Gay St Manchester NH 03103-7097 |
Mailing Address |
355 Hackett Hill Rd Hooksett NH 03106-2516 |
Practice Telephone | 3155730705 |
Mailing Telephone | 3155730705 |
Enumeration Date | 2020-07-06 |
Last Update Date | 2020-09-28 |
Authorized Official Name | ALEXIS BRUNELLE (PHYSICAL THERAPIST, CO-OWNER) |
Authorized Official Telephone | 3155730705 |
Authorized Official Credential | PT, DPT |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
Street Address |
200 GAY ST |
City | MANCHESTER |
State | NH |
Zip Code | 03103-7097 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023583374 | Melissa K Bascom | Social Worker | C/o Care Coordination Department, 1 Elliot Way, Manchester, NH 03103 | 2018-10-12 |
1538650650 | Bluestone Healthcare Services L.L.C. | Physician Assistant | Bluestone Healthcare Services LLC 169 South River Rd, Bedford, NH 03103 | 2018-05-24 |
1538662424 | Minal Jamkhande | Pharmacist | 50 S Willow Street, Manchester, NH 03103 | 2018-03-16 |
1447776240 | Manchester Health Supplies | Durable Medical Equipment & Medical Supplies | 373 S Willow Street, #328, Manchester, NH 03103 | 2017-08-14 |
1184145898 | Susan E Herman | Physical Therapist | 3000 Goffs Falls Road Suite 101, Manchester, NH 03103 | 2017-07-03 |
1316476757 | Sara Rose Hanrahan | Occupational Therapist | 3000 Goffs Falls Road, Suite 101, Manchester, NH 03103 | 2017-06-08 |
1457802811 | Holly Ann Cekala | Counselor | 140 Central St, Manchester, NH 03103 | 2016-10-20 |
1114301249 | Families In Transition | Counselor | 282 Belmont St, Manchester, NH 03103 | 2015-07-18 |
1083092282 | Alexander Michael Jones | Family Medicine | 4 Elliot Way Ste 105, Manchester, NH 03103 | 2015-05-08 |
1518344100 | Janiris Ruth Matos | Dentist | 8 Vinton Street, Dental Clinic, Manchester, NH 03103 | 2015-05-03 |
Find all providers in zip 03103 |
Taxonomy Code | 261QP2000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Physical Therapy |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942550025 | Occupational Health Centers of The Southwest Pa | Clinic/Center | 1279 S Willow St, Suite E, Manchester, NH 03103-4015 | 2012-09-14 |
1205130200 | Cumberland Outpatient Rehab, LLC | Clinic/Center | 2983 South Hwy 421, Manchester, KY 40962-6212 | 2011-01-05 |
1043436488 | Connecticut Soundside Physical Therapy Homecare, PC | Clinic/Center | 184 New State Rd, Apt 38, Manchester, CT 06042-7943 | 2007-04-17 |
1326006222 | Clemson Sports Medicine and Rehabilitation, Inc | Clinic/Center | 1140 Warm Springs Hwy, Manchester, GA 31816-1166 | 2006-05-02 |
1154777381 | Pt for Life LLC | Clinic/Center | 33 Union St, Manchester, MA 01944-1555 | 2016-05-06 |
1184082257 | Sokolski Physical Therapy, LLC | Clinic/Center | 230 Deming St, Main Office, Manchester, CT 06042-1778 | 2016-02-04 |
1619393337 | Ptsma Inc | Clinic/Center | 360 Tolland Tpke, Suite 2e, Manchester, CT 06042-1771 | 2014-03-06 |
1346421559 | Superior Physical Therapy,llc | Clinic/Center | 700 Lake Ave, Suite 3, Manchester, NH 03103-2734 | 2007-11-15 |
1053470492 | Cpte - Manchester, Inc. | Clinic/Center | 20 S Main St, Manchester, NH 03102-4405 | 2006-12-08 |
1972661197 | Alpine Physical Therapy & Sports Care, P.C. | Clinic/Center | 3800 Main Street, Manchester, VT 05254 | 2006-12-04 |
Find all providers in MANCHESTER |
City | MANCHESTER |
Zip Code | 03103 |
Please comment or provide details below to improve the information on RENEGADE MOVEMENT AND PERFORMANCE, LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.