Healthcare Provider Details

I. General information

NPI: 1659071215
Provider Name (Legal Business Name): KALISA SUSANNE ZURIS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MILLBURY BLVD
OXFORD MA
01540-1300
US

IV. Provider business mailing address

520 DUTCHESS ST
SPRINGFIELD MA
01129-1707
US

V. Phone/Fax

Practice location:
  • Phone: 508-859-4394
  • Fax:
Mailing address:
  • Phone: 415-799-6083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL26691
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: