Healthcare Provider Details

I. General information

NPI: 1700599313
Provider Name (Legal Business Name): SERVICENET, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2022
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 MAIN ST 1ST FLOOR
HOLYOKE MA
01040
US

IV. Provider business mailing address

21 OLANDER DRIVE
NORTHHAMPTON MA
01060
US

V. Phone/Fax

Practice location:
  • Phone: 413-588-7235
  • Fax:
Mailing address:
  • Phone: 413-585-1300
  • Fax: 413-585-1355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELLEN M WERNER
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 413-588-7235