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NPI Code Detail

MEDICARE: MARTIN CONSERVA DPT

MEDICARE:   MARTIN  CONSERVA  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
1225100000XPhysical Therapist26165MA

General Provider Information

NPI Number : 1467037077
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTIN CONSERVA DPT
Provider Business Mailing Address
First Line : 247 S HIGHWAY 101
Second Line :
City : SOLANA BEACH
State : CA
Zip : 92075-1807
Country : US
Telephone Number : 760-230-5432
Fax Number :
Provider Business Practice Location Address
First Line : 1373 HIGHLAND ST
Second Line :
City : HOLLISTON
State : MA
Zip : 01746-2627
Country : US
Telephone Number : 781-290-7430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2021
Last Update Date : 03/26/2023

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Directions to “ MARTIN CONSERVA DPT” Practice Location

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