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General NPI Number Information
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NPI Number | 1477889483
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Entity Type | Organization
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Legal Business Name | BOSTON PAIN & REHAB CENTER,INC
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 524 HARVARD ST
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City | BROOKLINE
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State | MA
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Zip | 02446-2463
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Country | US
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Telephone | 617-630-9900
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Fax | 617-731-1001
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Provider Business Mailing Address
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Address Line | 524 HARVARD ST
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City | BROOKLINE
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State | MA
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Zip | 02446-2463
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Country | US
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Telephone | 617-630-9900
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Fax | 617-731-1001
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHANG YOON
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Credential | PT.,DPT
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Telephone | 617-630-9900
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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 | 18660
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License Number State | MA
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