MEDICARE: INTEGRATED ORTHOPEDIC PHYSICAL THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1467846279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED ORTHOPEDIC PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	334 COLLEGE ST
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-2331
Country	:	US
Telephone Number	:	413-992-2131
Fax Number	:	413-992-2134

Provider Business Practice Location Address
First Line	:	334 COLLEGE ST
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-2331
Country	:	US
Telephone Number	:	413-992-2131
Fax Number	:	413-992-2134

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KATHLEEN R MCCAULEY
Credential	:
Telephone Number	:	413-992-2131

Provider Enumeration Date	:	03/19/2015
Last Update Date	:	11/05/2019

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