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General NPI Number Information
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NPI Number | 1922532282
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Entity Type | Individual
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Provider Name | MATTHEW KRAFT P.T.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 1914 CENTRE ST
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City | WEST ROXBURY
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State | MA
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Zip | 02132
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Country | US
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Telephone | 617-323-8377
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Fax | 617-323-8077
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Provider Business Mailing Address
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Address Line | 1 CREDIT UNION WAY FL 3
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City | RANDOLPH
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State | MA
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Zip | 02368-4633
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Country | US
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Telephone | 781-961-3370
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Fax | 781-961-1291
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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 | 22720
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License Number State | MA
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