Healthcare Provider Details

I. General information

NPI: 1386378933
Provider Name (Legal Business Name): EMBRACE PELVIC HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402A HIGHLAND AVE RM G
SOMERVILLE MA
02144-2511
US

IV. Provider business mailing address

66 LEXINGTON AVE APT 2
SOMERVILLE MA
02144-2610
US

V. Phone/Fax

Practice location:
  • Phone: 617-996-1060
  • Fax:
Mailing address:
  • Phone: 301-325-5582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIANNA ALLEN
Title or Position: OWNER
Credential: DPT
Phone: 301-325-5582