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General NPI Number Information
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NPI Number | 1699575985
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Entity Type | Organization
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Legal Business Name | BACK 9 PHYSICAL THERAPY AND PERFORMANCE
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Dates
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Enumeration Date | 03/15/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 350 MASSACHUSETTS AVE
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City | CAMBRIDGE
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State | MA
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Zip | 02139-4182
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Country | US
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Telephone | 617-802-8036
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Fax |
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Provider Business Mailing Address
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Address Line | 168 WALNUT ST APT 6
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City | WATERTOWN
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State | MA
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Zip | 02472-4035
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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 | MANAGER
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Name | MR. DONALD FEENEY JR.
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Credential | DPT
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Telephone | 617-802-8036
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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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