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NPI Code Detail

MEDICARE: EDWARD JOSEPH PERKINS ATC

MEDICARE: EDWARD JOSEPH PERKINS ATC
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
12255A2300XAthletic Trainer586MA

General Provider Information

NPI Number : 1801902770
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD JOSEPH PERKINS ATC
Provider Business Mailing Address
First Line : 11 STANDISH RD
Second Line :
City : MILTON
State : MA
Zip : 02186-2813
Country : US
Telephone Number : 617-296-0121
Fax Number :
Provider Business Practice Location Address
First Line : 100 WILLIAM T MORRISSEY BLVD
Second Line :
City : DORCHESTER
State : MA
Zip : 02125-3300
Country : US
Telephone Number : 617-287-7818
Fax Number : 617-287-7870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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Directions to “ EDWARD JOSEPH PERKINS ATC” Practice Location

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