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General NPI Number Information
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NPI Number | 1083833966
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Entity Type | Organization
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Legal Business Name | ACTIVECARE PHYSICAL THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 305 HOKUM ROCK RD
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-2357
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Country | US
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Telephone | 508-385-1900
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Fax | 508-546-3050
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Provider Business Mailing Address
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Address Line | 305 HOKUM ROCK RD
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-2357
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Country | US
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Telephone | 508-385-1900
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Fax | 508-546-3050
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEPHEN R. LOOMIS
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Credential | MPT
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Telephone | 508-385-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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