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General NPI Number Information
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NPI Number | 1629833892
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PERFORMANCE AND PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 127 RODNEY FRENCH BLVD
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City | NEW BEDFORD
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State | MA
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Zip | 02744-1623
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Country | US
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Telephone | 608-287-3604
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Fax |
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Provider Business Mailing Address
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Address Line | 112 PLEASANT ST
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City | FAIRHAVEN
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State | MA
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Zip | 02719-3931
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | SAMANTHA OLSEN
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Credential |
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Telephone | 508-287-3604
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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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