Healthcare Provider Details

I. General information

NPI: 1013135441
Provider Name (Legal Business Name): KENNEDY BROTHERS PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 CHIEF JUSTICE CUSHING HWY
COHASSET MA
02025-2140
US

IV. Provider business mailing address

790 CHIEF JUSTICE CUSHING HWY
COHASSET MA
02025-2140
US

V. Phone/Fax

Practice location:
  • Phone: 781-383-8001
  • Fax: 781-383-8009
Mailing address:
  • Phone: 781-383-8001
  • Fax: 781-383-8009

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: MS. LAURA COLLINS
Title or Position: ADMINISTRATOR
Credential:
Phone: 617-372-6317