| NPI | 1275644270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LEDOUX Practice Manager 508-791-8740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-12-08 |