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General NPI Number Information
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NPI Number | 1407095771
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Entity Type | Organization
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Legal Business Name | METROWEST OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 61 BROWN ST
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City | WALTHAM
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State | MA
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Zip | 02453-3915
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Country | US
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Telephone | 781-650-6782
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Fax |
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Provider Business Mailing Address
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Address Line | 475 FRANKLIN ST 201
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City | FRAMINGHAM
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State | MA
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Zip | 01702-6264
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Country | US
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Telephone | 508-877-5525
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATINA LAWDIS
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Credential |
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Telephone | 508-877-5525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 3863
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License Number State | MA
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