Healthcare Provider Details

I. General information

NPI: 1215920384
Provider Name (Legal Business Name): TRAVIS E. SCHOEN MSPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 MAIN ST SUITE 103
SOUTH WEYMOUTH MA
02190-1868
US

IV. Provider business mailing address

46 ROSEMONT ST #2
DORCHESTER MA
02122-2449
US

V. Phone/Fax

Practice location:
  • Phone: 781-331-9600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13238
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: