Healthcare Provider Details

I. General information

NPI: 1093498099
Provider Name (Legal Business Name): ORTHOLAZER ORTHOPEDIC LASER CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 CHELMSFORD ST
CHELMSFORD MA
01824-2305
US

IV. Provider business mailing address

227 CHELMSFORD ST
CHELMSFORD MA
01824-2305
US

V. Phone/Fax

Practice location:
  • Phone: 978-856-7676
  • Fax: 978-856-7230
Mailing address:
  • Phone: 978-856-7676
  • Fax: 978-856-7230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT SIGMAN
Title or Position: OWNER/MANAGER
Credential: MD
Phone: 978-856-7676