Healthcare Provider Details

I. General information

NPI: 1922297886
Provider Name (Legal Business Name): ACHIEVE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 MASS AVE STE 302
ACTON MA
01720-3739
US

IV. Provider business mailing address

411 MASS AVE STE 302
ACTON MA
01720-3739
US

V. Phone/Fax

Practice location:
  • Phone: 978-263-0007
  • Fax: 978-263-0014
Mailing address:
  • Phone: 978-263-0007
  • Fax: 978-263-0014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number15629
License Number StateMA

VIII. Authorized Official

Name: ROBERT THOMAS
Title or Position: OWNER
Credential:
Phone: 978-263-0007