Healthcare Provider Details

I. General information

NPI: 1164421293
Provider Name (Legal Business Name): PATRICIA W. OBRIEN P.T., DPT, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 CARLON DR
NORTHAMPTON MA
01060-2392
US

IV. Provider business mailing address

588 MAIN RD
CHESTERFIELD MA
01012-9701
US

V. Phone/Fax

Practice location:
  • Phone: 413-727-3315
  • Fax: 413-727-3316
Mailing address:
  • Phone: 413-296-4365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6680
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: