Healthcare Provider Details

I. General information

NPI: 1235359951
Provider Name (Legal Business Name): KENNEDY BROTHERS PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BRAINTREE HILL PARK
BRAINTREE MA
02184-8702
US

IV. Provider business mailing address

25 BRAINTREE HILL PARK
BRAINTREE MA
02184-8702
US

V. Phone/Fax

Practice location:
  • Phone: 781-848-7300
  • Fax: 781-848-5678
Mailing address:
  • Phone: 781-848-7300
  • Fax: 781-848-5678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN KENNEDY
Title or Position: OWNER
Credential:
Phone: 617-542-6611