Healthcare Provider Details

I. General information

NPI: 1366414211
Provider Name (Legal Business Name): HINGHAM PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2006
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 LINCOLN ST UNIT C
HINGHAM MA
02043-1718
US

IV. Provider business mailing address

184 LINCOLN ST UNIT C
HINGHAM MA
02043-1718
US

V. Phone/Fax

Practice location:
  • Phone: 781-740-4900
  • Fax: 781-740-4930
Mailing address:
  • Phone: 781-740-4900
  • Fax: 781-740-4930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateMA

VIII. Authorized Official

Name: MRS. CHRISTINE E SAN ANTONIO
Title or Position: CO-OWNER
Credential: P.T.
Phone: 781-740-4900