| NPI | 1427593102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES J ANTZAK Owner 617-359-7120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: MA 1162) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-03-02 |