Healthcare Provider Details

I. General information

NPI: 1548558448
Provider Name (Legal Business Name): GREAT BARRINGTON PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 MAIN ST SUITE 4
GREAT BARRINGTON MA
01230-2217
US

IV. Provider business mailing address

789 MAIN ST SUITE 4
GREAT BARRINGTON MA
01230-2217
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-0929
  • Fax: 413-528-6123
Mailing address:
  • Phone: 413-528-0929
  • Fax: 413-528-6123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBORAH J KAIN
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 413-528-0929