Healthcare Provider Details

I. General information

NPI: 1770477531
Provider Name (Legal Business Name): MICHAELA ZIMMERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 TRAPELO RD
BELMONT MA
02478-1417
US

IV. Provider business mailing address

61 COUNTRY CLUB CIRCLE
NORTH ANDOVER MA
01845
US

V. Phone/Fax

Practice location:
  • Phone: 617-932-1027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: