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NPI Code Detail

MEDICARE: DR. STACEY L RAYBUCK DPT

MEDICARE: DR. STACEY L RAYBUCK DPT
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
12251X0800XOrthopedic Physical Therapist6929MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053319848
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STACEY L RAYBUCK DPT
Provider Business Mailing Address
First Line : 6 HIGHCROFT WAY
Second Line :
City : HOPKINTON
State : MA
Zip : 01748-1299
Country : US
Telephone Number : 508-528-6100
Fax Number : 508-528-6304
Provider Business Practice Location Address
First Line : 620 OLD WEST CENTRAL ST
Second Line :
City : FRANKLIN
State : MA
Zip : 02038-2912
Country : US
Telephone Number : 508-528-6100
Fax Number : 508-528-6304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 01/30/2012

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