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General NPI Number Information
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NPI Number | 1972327534
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Entity Type | Organization
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Legal Business Name | BRIDGEWATER PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 620 BEDFORD ST
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City | BRIDGEWATER
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State | MA
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Zip | 02324-3180
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Country | US
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Telephone | 508-807-0146
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Fax | 508-807-0134
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Provider Business Mailing Address
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Address Line | 620 BEDFORD ST
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City | BRIDGEWATER
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State | MA
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Zip | 02324-3180
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Country | US
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Telephone | 508-807-0146
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Fax | 508-807-0134
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Authorized Official
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Title or Position | OWNER, DPT
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Name | MR. PETER DAVID MELLO
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Credential | DPT
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Telephone | 508-807-0146
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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 |
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License Number State |
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