MEDICARE: ALYSSA PERREAULT 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	16916	MA

General Provider Information

NPI Number	:	1801842620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA PERREAULT PT

Provider Business Mailing Address
First Line	:	2 PATRIOT PL
Second Line	:
City	:	FOXBORO
State	:	MA
Zip	:	02035-1375
Country	:	US
Telephone Number	:	508-718-4040
Fax Number	:	508-718-4041

Provider Business Practice Location Address
First Line	:	2 PATRIOT PL
Second Line	:
City	:	FOXBORO
State	:	MA
Zip	:	02035-1375
Country	:	US
Telephone Number	:	508-718-4040
Fax Number	:	508-718-4041

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	04/01/2014

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Directions to “ ALYSSA PERREAULT PT” Practice Location

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