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General NPI Number Information
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NPI Number | 1083458509
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Entity Type | Organization
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Legal Business Name | MIGHTY MILESTONES PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 16 ROWLEY HILL RD
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City | STERLING
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State | MA
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Zip | 01564-2123
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Country | US
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Telephone | 978-496-9008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 834
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City | STERLING
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State | MA
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Zip | 01564-0834
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LLC MEMBER MANAGER
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Name | JOCELYNE MACDONALD
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Credential |
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Telephone | 978-496-9008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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