Healthcare Provider Details

I. General information

NPI: 1912828765
Provider Name (Legal Business Name): WELLESLEY CONCIERGE PT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47A RIVER ST STE A100
WELLESLEY MA
02481-2018
US

IV. Provider business mailing address

3 GRAY FARM RD
LITTLETON MA
01460-1283
US

V. Phone/Fax

Practice location:
  • Phone: 781-277-7210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CONOR NORDENGREN
Title or Position: OWNER
Credential:
Phone: 978-495-2850