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General NPI Number Information
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NPI Number | 1528060118
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Entity Type | Individual
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Provider Name | JOSEPH S O CONNOR PT SCS
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 39 CROSS ST SUITE 205
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City | PEABODY
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State | MA
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Zip | 01960-1670
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Country | US
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Telephone | 978-538-7370
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Fax | 978-538-7372
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Provider Business Mailing Address
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Address Line | 1 MARKET ST 3RD FLOOR
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City | LYNN
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State | MA
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Zip | 01901-1011
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Country | US
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Telephone | 781-592-0540
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Fax | 781-592-0989
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 6761
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License Number State | MA
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