MEDICARE: D4 PHYSICAL THERAPY SOUTH SHORE 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1952253320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D4 PHYSICAL THERAPY SOUTH SHORE LLC

Provider Business Mailing Address
First Line	:	228 COLUMBIA RD
Second Line	:
City	:	HANOVER
State	:	MA
Zip	:	02339-2398
Country	:	US
Telephone Number	:	781-603-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	228 COLUMBIA RD
Second Line	:
City	:	HANOVER
State	:	MA
Zip	:	02339-2398
Country	:	US
Telephone Number	:	781-603-9777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER DOYLE
Credential	:
Telephone Number	:	781-603-9777

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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