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General NPI Number Information
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NPI Number | 1821888637
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Entity Type | Individual
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Provider Name | JOHN STOCKBRIDGE
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Gender |
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 164 PARKINGWAY
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City | QUINCY
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State | MA
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Zip | 02169-5020
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Country | US
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Telephone | 617-773-4222
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Fax |
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Provider Business Mailing Address
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Address Line | 39 CHURCH ST
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City | MILTON
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State | MA
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Zip | 02186-5511
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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 |
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | OTL36043
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTL36043
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License Number State | MA
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