MEDICARE: MARYANN COVELLE 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	8024	MA

General Provider Information

NPI Number	:	1184037384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYANN COVELLE PT

Provider Business Mailing Address
First Line	:	320 CENTRAL ST
Second Line	:
City	:	SAUGUS
State	:	MA
Zip	:	01906-2371
Country	:	US
Telephone Number	:	781-233-4122
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 CENTRAL ST
Second Line	:
City	:	SAUGUS
State	:	MA
Zip	:	01906-2371
Country	:	US
Telephone Number	:	781-233-4122
Fax Number	:

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

Provider Enumeration Date	:	06/04/2014
Last Update Date	:	06/04/2014

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Directions to “ MARYANN COVELLE PT” Practice Location

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