MEDICARE: PRESCRIPTION ORTHOPEDIC AND SPORTS THERAPY

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1588641807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESCRIPTION ORTHOPEDIC AND SPORTS THERAPY

Provider Business Mailing Address
First Line	:	235 CYPRESS ST
Second Line	:	SUITE 100
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6776
Country	:	US
Telephone Number	:	617-738-1004
Fax Number	:	617-731-4162

Provider Business Practice Location Address
First Line	:	235 CYPRESS ST
Second Line	:	SUITE 100
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6776
Country	:	US
Telephone Number	:	617-738-1004
Fax Number	:	617-731-4162

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	PETER STONE
Credential	:
Telephone Number	:	617-729-1004

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	01/29/2008

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Directions to “PRESCRIPTION ORTHOPEDIC AND SPORTS THERAPY ” Practice Location

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