MEDICARE: LC HOLBROOK, 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	225100000X	Physical Therapist	13235	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922129642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LC HOLBROOK, INC.

Provider Business Mailing Address
First Line	:	19 LANCELOT LN
Second Line	:
City	:	NORTH EASTON
State	:	MA
Zip	:	02356-2720
Country	:	US
Telephone Number	:	781-864-5499
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 N FRANKLIN ST
Second Line	:
City	:	HOLBROOK
State	:	MA
Zip	:	02343-1174
Country	:	US
Telephone Number	:	781-767-5200
Fax Number	:	781-767-5202

Authorized Official
Title or Position	:	OWNER
Name	:	MARK KAROUL
Credential	:	PT
Telephone Number	:	781-864-6190

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/31/2019

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Directions to “LC HOLBROOK, INC. ” Practice Location

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