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NPI 1225742554

NPI 1225742554 : EMBODY PHYSICAL THERAPY & WELLNESS, LLC : HOPKINTON, MA

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General NPI Number Information
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    NPI Number           |    1225742554
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    Entity Type          |    Organization 
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    Legal Business Name  |    EMBODY PHYSICAL THERAPY & WELLNESS, LLC 
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Dates
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    Enumeration Date     |    01/11/2023
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    Last Update Date     |    01/13/2023
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Provider Practice Location Address
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    Address Line         |    58 LAKESHORE DR 
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    City                 |    HOPKINTON
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    State                |    MA
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    Zip                  |    01748-2712
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    Country              |    US
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    Telephone            |    508-269-4091
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    58 LAKESHORE DR 
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    City                 |    HOPKINTON
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    State                |    MA
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    Zip                  |    01748-2712
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MRS. EMILY  EVERTON 
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    Credential           |    PT, DPT
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    Telephone            |    508-269-4091
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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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