Healthcare Provider Details

I. General information

NPI: 1225087133
Provider Name (Legal Business Name): QUALITY PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 04/30/2024
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 MAIN ST
STURBRIDGE MA
01566-1569
US

IV. Provider business mailing address

135 MAIN ST
STURBRIDGE MA
01566-1569
US

V. Phone/Fax

Practice location:
  • Phone: 508-347-8141
  • Fax: 508-347-7576
Mailing address:
  • Phone: 508-347-8141
  • Fax: 508-347-7576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberGROUP
License Number StateMA

VIII. Authorized Official

Name: CHERYL WILBUR
Title or Position: OWNER
Credential: PT
Phone: 508-347-8141