Healthcare Provider Details

I. General information

NPI: 1356319271
Provider Name (Legal Business Name): KERRY M MORIN MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 NORTH MAIN STREET
BELLINGHAM MA
02019
US

IV. Provider business mailing address

26 ASYLUM ST.
MILFORD MA
01757
US

V. Phone/Fax

Practice location:
  • Phone: 508-966-2717
  • Fax: 508-966-2095
Mailing address:
  • Phone: 508-473-0400
  • Fax: 508-473-3440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number15969
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: