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General NPI Number Information
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NPI Number | 1831430842
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Entity Type | Organization
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Legal Business Name | MARIBETH CRUPI PHYSICAL THERPAY LLC
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Dates
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Enumeration Date | 03/15/2013
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Last Update Date | 01/21/2014
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Provider Practice Location Address
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Address Line | 10 ELIZABETH DRIVE
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City | WILMINGTON
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State | MA
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Zip | 01887
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Country | US
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Telephone | 978-203-0665
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Fax | 978-203-0667
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Provider Business Mailing Address
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Address Line | 10 ELIZABETH DRIVE
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City | WILMINGTON
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State | MA
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Zip | 01887
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Country | US
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Telephone | 978-203-0665
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Fax | 978-203-0667
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | MRS. MARIBETH CRUPI
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Credential | PT
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Telephone | 978-203-0665
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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 | 5468
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License Number State | MA
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