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General NPI Number Information
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NPI Number | 1962837799
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Entity Type | Organization
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Legal Business Name | VILLAGE PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 10/21/2014
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Provider Practice Location Address
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Address Line | 203 POPES IS
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City | NEW BEDFORD
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State | MA
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Zip | 02740-7232
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Country | US
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Telephone | 508-542-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 203 POPES IS
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City | NEW BEDFORD
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State | MA
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Zip | 02740-7232
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Country | US
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Telephone | 508-542-9888
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Fax | 508-991-5505
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | PHILIP C HUBERT
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Credential |
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Telephone | 508-542-9888
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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 | 10763
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License Number State | MA
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