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General NPI Number Information
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NPI Number | 1437278744
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Entity Type | Organization
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Legal Business Name | BODY WORKS PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 103 MARKET ST
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City | LOWELL
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State | MA
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Zip | 01852-1807
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Country | US
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Telephone | 978-452-6121
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Fax | 978-452-8991
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Provider Business Mailing Address
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Address Line | 103 MARKET ST
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City | LOWELL
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State | MA
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Zip | 01852-1807
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Country | US
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Telephone | 978-452-6121
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Fax | 978-452-8991
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Authorized Official
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Title or Position | DIRECTOR OF REHAB SERVICES
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Name | MICHELLE ANITA SHEPARD
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Credential | DPT
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Telephone | 978-452-6121
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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 | 130
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License Number State | MA
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