Healthcare Provider Details

I. General information

NPI: 1194387191
Provider Name (Legal Business Name): BAY STATE PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 WASHINGTON ST
ATTLEBORO MA
02703-7944
US

IV. Provider business mailing address

703 GRANITE ST STE 300
BRAINTREE MA
02184-5350
US

V. Phone/Fax

Practice location:
  • Phone: 508-761-5945
  • Fax: 508-761-9111
Mailing address:
  • Phone: 781-961-3370
  • Fax: 781-961-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRADEN HILL
Title or Position: CEO
Credential:
Phone: 339-987-4428