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General NPI Number Information
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NPI Number | 1437508421
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Entity Type | Organization
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Legal Business Name | DOCTORS PHYSIO,INC
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/09/2016
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Provider Practice Location Address
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Address Line | 221 MOODY ST
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City | WALTHAM
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State | MA
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Zip | 02453-5322
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Country | US
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Telephone | 617-731-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 221 MOODY ST
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City | WALTHAM
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State | MA
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Zip | 02453-5322
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Country | US
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Telephone | 617-731-1001
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | EDWARD SEGEL
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Credential | PT
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Telephone | 617-731-1004
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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 | 18216
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License Number State | MA
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