MEDICARE: KOMAL RATHOD MSPT

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	24121	MA

General Provider Information

NPI Number	:	1962963314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOMAL RATHOD MSPT

Provider Business Mailing Address
First Line	:	2 REDWOOD PATH
Second Line	:
City	:	HOPKINTON
State	:	MA
Zip	:	01748-1326
Country	:	US
Telephone Number	:	508-834-2781
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 NORTHBORO RD E
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-1844
Country	:	US
Telephone Number	:	508-485-4040
Fax Number	:

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

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	04/06/2023

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