MEDICARE: OCCUPATIONAL ORTHOPEDIC SURGERY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM1300X	Multi-Specialty Clinic/Center
2	111N00000X	Chiropractor
3	225100000X	Physical Therapist
4	225700000X	Massage Therapist
5	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1639333214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL ORTHOPEDIC SURGERY LLC

Provider Business Mailing Address
First Line	:	PO BOX 550226
Second Line	:
City	:	NORTH WALTHAM
State	:	MA
Zip	:	02455-0226
Country	:	US
Telephone Number	:	781-235-3992
Fax Number	:	781-235-3996

Provider Business Practice Location Address
First Line	:	111 EVERETT AVE
Second Line	:	SUITE 1A
City	:	CHELSEA
State	:	MA
Zip	:	02150-2385
Country	:	US
Telephone Number	:	781-235-3992
Fax Number	:	781-235-3996

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM FRANCIS MULROY
Credential	:	M.D.
Telephone Number	:	781-235-3992

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	04/20/2017

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