| NPI | 1245469477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LOUIS PROVENZANO Owner 978-686-7111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2020-06-18 |