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General NPI Number Information
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NPI Number | 1831134014
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Entity Type | Organization
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Legal Business Name | THERAFIT 1 AT RIVEREDGE, INC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 176 WALKER ST
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City | LOWELL
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State | MA
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Zip | 01854-3126
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Country | US
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Telephone | 978-452-9252
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Fax | 978-970-0271
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Provider Business Mailing Address
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Address Line | 176 WALKER ST
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City | LOWELL
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State | MA
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Zip | 01854-3126
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Country | US
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Telephone | 978-452-9252
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Fax | 978-970-0271
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Authorized Official
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Title or Position | TREASURER / DIRECTOR
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Name | MR. DARIN MCCARTHY
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Credential | MSPT
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Telephone | 978-452-9252
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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 | 11098
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License Number State | MA
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