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General NPI Number Information
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NPI Number | 1366766586
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Entity Type | Organization
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Legal Business Name | ATLANTIC REHABILITATION SERVICES, INC
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 4197 WASHINGTON ST.
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City | ROSLINDALE
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State | MA
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Zip | 02131
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Country | US
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Telephone | 617-323-8880
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Fax | 617-323-8886
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Provider Business Mailing Address
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Address Line | 4197 WASHINGTON ST.
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City | ROSLINDALE
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State | MA
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Zip | 02131
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Country | US
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Telephone | 617-323-8880
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Fax | 617-323-8886
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALEX PYATIGORSKIY
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Credential |
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Telephone | 617-721-6281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 564
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License Number State | MA
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