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General NPI Number Information
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NPI Number | 1871733295
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Entity Type | Individual
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Provider Name | JUSTIN PATRICK PARADIS PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 205 LINDEN PONDS WAY OP REHAB CLINIC
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City | HINGHAM
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State | MA
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Zip | 02043-8714
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Country | US
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Telephone | 781-435-7160
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Fax | 781-534-7382
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Provider Business Mailing Address
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Address Line | 205 LINDEN PONDS WAY OP REHAB CLINIC
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City | HINGHAM
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State | MA
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Zip | 02043-8714
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Country | US
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Telephone | 781-435-7160
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Fax | 781-534-7382
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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 | 17487
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License Number State | MA
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