MEDICARE: BOSTON THERAPY INC

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	174400000X	Specialist	10941	MA

General Provider Information

NPI Number	:	1558501403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON THERAPY INC

Provider Business Mailing Address
First Line	:	50 MERIDIAN ST STE 2
Second Line	:
City	:	EAST BOSTON
State	:	MA
Zip	:	02128-3216
Country	:	US
Telephone Number	:	617-561-7246
Fax Number	:	617-561-7247

Provider Business Practice Location Address
First Line	:	50 MERIDIAN ST STE 2
Second Line	:
City	:	EAST BOSTON
State	:	MA
Zip	:	02128-3216
Country	:	US
Telephone Number	:	617-561-7246
Fax Number	:	617-561-7247

Authorized Official
Title or Position	:	OWNER
Name	:	MR. STEVAN CRAIG SIMON
Credential	:	PT, MT
Telephone Number	:	617-561-7246

Provider Enumeration Date	:	03/04/2009
Last Update Date	:	05/22/2013

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Directions to “BOSTON THERAPY INC ” Practice Location

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