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General NPI Number Information
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NPI Number | 1225161193
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Entity Type | Organization
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Legal Business Name | MARATHON PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 250 E MAIN ST
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City | NORTON
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State | MA
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Zip | 02766-2436
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Country | US
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Telephone | 508-285-5533
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Fax | 508-285-7977
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Provider Business Mailing Address
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Address Line | 250 E MAIN ST
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City | NORTON
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State | MA
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Zip | 02766-2436
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Country | US
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Telephone | 508-285-5533
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Fax | 508-285-7977
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. JESSICA LEIGH MCKINNEY
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Credential | MS, PT
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Telephone | 508-285-5533
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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 | 273
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License Number State | MA
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