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General NPI Number Information
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NPI Number | 1174402564
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Entity Type | Individual
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Provider Name | PHILIP W BUCHANAN MASSAGE THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 850 BOYLSTON ST STE 422
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City | CHESTNUT HILL
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State | MA
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Zip | 02467-2402
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Country | US
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Telephone | 617-732-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 30 GARY RD
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City | NEEDHAM
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State | MA
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Zip | 02494-2417
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Country | US
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Telephone | 617-832-5680
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 3484
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License Number State | MA
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