Healthcare Provider Details

I. General information

NPI: 1265462113
Provider Name (Legal Business Name): DOWNTOWN PHYSICAL THERAPY AND REHABILITATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 06/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 ATLANTIC AVE 125 LEWIS WHARF
BOSTON MA
02110-3802
US

IV. Provider business mailing address

28 ATLANTIC AVE 125 LEWIS WHARF
BOSTON MA
02110-3802
US

V. Phone/Fax

Practice location:
  • Phone: 617-523-2766
  • Fax: 617-523-3063
Mailing address:
  • Phone: 617-523-2766
  • Fax: 617-523-3063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3630
License Number StateMA

VIII. Authorized Official

Name: MARCO VOLPE
Title or Position: OWNER
Credential: DPT OCS
Phone: 617-523-2766