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General NPI Number Information
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NPI Number | 1184029183
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Entity Type | Organization
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Legal Business Name | PROVINCETOWN PHYSICAL THERAPY
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Dates
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Enumeration Date | 11/03/2014
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Last Update Date | 11/03/2014
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Provider Practice Location Address
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Address Line | 30 CONWELL ST OFFICE #1
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City | PROVINCETOWN
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State | MA
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Zip | 02657-1548
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Country | US
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Telephone | 774-216-0834
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Fax | 508-487-1218
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Provider Business Mailing Address
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Address Line | 30 CONWELL ST OFFICE #1
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City | PROVINCETOWN
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State | MA
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Zip | 02657-1548
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Country | US
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Telephone | 774-216-0834
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Fax | 508-487-1218
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MS. CYNTHIA ANNE FRANCO
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Credential | PT
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Telephone | 774-216-0834
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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 | 18493
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License Number State | MA
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