MEDICARE: EILEEN KURCON PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	6028	MA

General Provider Information

NPI Number	:	1023068517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EILEEN KURCON PT

Provider Business Mailing Address
First Line	:	325 AYER RD
Second Line	:
City	:	HARVARD
State	:	MA
Zip	:	01451-1132
Country	:	US
Telephone Number	:	978-772-8100
Fax Number	:	978-772-8102

Provider Business Practice Location Address
First Line	:	325 AYER RD
Second Line	:
City	:	HARVARD
State	:	MA
Zip	:	01451-1132
Country	:	US
Telephone Number	:	978-772-8100
Fax Number	:	978-772-8102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	10/24/2007

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Directions to “ EILEEN KURCON PT” Practice Location

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