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General NPI Number Information
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NPI Number | 1588066658
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Entity Type | Organization
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Legal Business Name | SHREWSBURY HEALTH CLUB
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Dates
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Enumeration Date | 09/20/2014
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Last Update Date | 09/20/2014
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Provider Practice Location Address
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Address Line | 80 LOCUST AVE B-103
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City | WORCESTER
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State | MA
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Zip | 01604-1160
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Country | US
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Telephone | 508-335-1268
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Fax |
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Provider Business Mailing Address
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Address Line | 80 LOCUST AVE B-103
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City | WORCESTER
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State | MA
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Zip | 01604-1160
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Country | US
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Telephone | 508-335-1268
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Fax |
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Authorized Official
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Title or Position | AQUATIC/FACILITY MANAGER
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Name | MS. ANN JUDE MONAHAN
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Credential |
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Telephone | 508-845-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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