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General NPI Number Information
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NPI Number | 1114016847
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Entity Type | Organization
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Legal Business Name | ONE80 PHYSICAL THERAPY, LLC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 226 ANDOVER ST
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City | WILMINGTON
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State | MA
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Zip | 01887-1022
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Country | US
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Telephone | 978-658-1999
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Fax | 978-658-9994
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Provider Business Mailing Address
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Address Line | 226 ANDOVER ST
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City | WILMINGTON
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State | MA
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Zip | 01887-1022
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Country | US
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Telephone | 978-658-1999
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Fax | 978-658-9994
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Authorized Official
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Title or Position | DIRECTOR OF PHYSICAL THERAPY
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Name | MR. WILLIAM DOOLEY
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Credential | PT
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Telephone | 978-658-1999
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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 | 12144
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License Number State | MA
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