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General NPI Number Information
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NPI Number | 1841348505
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Entity Type | Organization
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Legal Business Name | PATRIOT ALL PRO PHYSICAL THERAPY CENTERS
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 348 N PEARL ST
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City | BROCKTON
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State | MA
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Zip | 02301-1197
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Country | US
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Telephone | 508-897-0056
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Fax | 508-584-5630
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Provider Business Mailing Address
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Address Line | 348 N PEARL ST
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City | BROCKTON
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State | MA
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Zip | 02301-1197
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Country | US
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Telephone | 508-897-0056
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Fax | 508-584-5630
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. RHONDA P. TIPPETT
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Credential |
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Telephone | 508-897-0056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 229
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License Number State | MA
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