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General NPI Number Information
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NPI Number | 1730337551
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Entity Type | Individual
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Provider Name | PETER A CONROD PT
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Gender | Male
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 502 BEDFORD ST
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City | FALL RIVER
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State | MA
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Zip | 02720-4855
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Country | US
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Telephone | 508-676-8251
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 757
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City | ASSONET
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State | MA
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Zip | 02702-0894
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Country | US
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Telephone | 508-644-5851
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2003
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT01457
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License Number State | RI
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