Healthcare Provider Details

I. General information

NPI: 1275457681
Provider Name (Legal Business Name): ASHLYN TAVARES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 WILLIAM S CANNING BLVD UNIT 3
FALL RIVER MA
02721-5603
US

IV. Provider business mailing address

703 GRANITE ST STE 3
BRAINTREE MA
02184-5350
US

V. Phone/Fax

Practice location:
  • Phone: 774-520-0033
  • Fax: 774-929-6692
Mailing address:
  • Phone: 781-961-3370
  • Fax: 781-961-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL89829
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: