Healthcare Provider Details

I. General information

NPI: 1033287339
Provider Name (Legal Business Name): CUMMINGS PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BARTLETT RD
WINTHROP MA
02152-2912
US

IV. Provider business mailing address

11 BARTLETT RD
WINTHROP MA
02152-2912
US

V. Phone/Fax

Practice location:
  • Phone: 617-846-0832
  • Fax:
Mailing address:
  • Phone: 617-846-0832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number4442
License Number StateMA

VIII. Authorized Official

Name: MR. KEVIN CUMMINGS
Title or Position: PRESIDENT
Credential: PT
Phone: 617-846-0832