Healthcare Provider Details

I. General information

NPI: 1386072403
Provider Name (Legal Business Name): FUSION PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 ASHLEY BLVD.
NEW BEDFORD MA
02745
US

IV. Provider business mailing address

PO BOX 838
WEST WAREHAM MA
02576-0838
US

V. Phone/Fax

Practice location:
  • Phone: 508-995-9000
  • Fax: 774-568-5613
Mailing address:
  • Phone: 774-766-0440
  • Fax: 774-568-5613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number11199
License Number StateMA

VIII. Authorized Official

Name: DEREK SALTZMAN
Title or Position: PRESIDENT
Credential:
Phone: 774-628-9169