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General NPI Number Information
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NPI Number | 1699179606
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD PHYSICAL THERAPY 1
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 337 WESTFORD ST
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City | LOWELL
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State | MA
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Zip | 01851-2519
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Country | US
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Telephone | 978-455-4320
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Fax | 978-455-4325
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Provider Business Mailing Address
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Address Line | 337 WESTFORD ST
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City | LOWELL
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State | MA
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Zip | 01851-2519
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Country | US
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Telephone | 978-455-4320
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Fax | 978-455-4325
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | MR. EDWARD SEGEL
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Credential | PT
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Telephone | 617-461-8277
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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 | 864
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License Number State | MA
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