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General NPI Number Information
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NPI Number | 1558883371
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Entity Type | Organization
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Legal Business Name | PADME PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 644 HIGH ST
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City | DEDHAM
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State | MA
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Zip | 02026-1857
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Country | US
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Telephone | 617-355-6657
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Fax |
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Provider Business Mailing Address
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Address Line | 644 HIGH ST
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City | DEDHAM
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State | MA
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Zip | 02026-1857
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Country | US
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Telephone | 617-355-6657
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Fax | 781-314-8163
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Authorized Official
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Title or Position | OWNER / PHYSICAL THERAPIST
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Name | ALICIA MOLLOY
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Credential | PT
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Telephone | 781-355-6657
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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 |
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License Number State |
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