Healthcare Provider Details

I. General information

NPI: 1770573628
Provider Name (Legal Business Name): LINDA C. MCKINNON P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CARRIAGE HOUSE WAY
MEDWAY MA
02053-2192
US

IV. Provider business mailing address

1 CARRIAGE HOUSE WAY
MEDWAY MA
02053-2192
US

V. Phone/Fax

Practice location:
  • Phone: 508-533-8185
  • Fax: 508-533-5452
Mailing address:
  • Phone: 508-533-8185
  • Fax: 508-533-5452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3392
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number3392
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: