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General NPI Number Information
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NPI Number | 1497769483
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Entity Type | Organization
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Legal Business Name | JUMP START PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 1 H F BROWN WAY
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City | NATICK
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State | MA
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Zip | 01760-3889
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Country | US
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Telephone | 508-647-1633
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Fax | 508-647-1634
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Provider Business Mailing Address
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Address Line | 1 H F BROWN WAY
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City | NATICK
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State | MA
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Zip | 01760-3889
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Country | US
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Telephone | 508-647-1633
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Fax | 508-647-1634
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/ OWNER
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Name | DANIEL M CONNORS
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Credential | PT, MS, CSCS, USAW
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Telephone | 508-647-1633
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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 | 11437
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License Number State | MA
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