Beantown Physio, INC
Physical Therapist in Brookline, MA. Organization (NPI-2).
NPI number1477547529
StatusActive
Last updated in NPPESOct 18, 2011
Details
- NPI
- 1477547529
- Entity type
- Organization (NPI-2)
- Legal business name
- Beantown Physio, INC
- Organization subpart
- No
- Enumeration date
- Sep 6, 2005
- Last updated
- Oct 18, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 16266 | MA | Yes |
| 225100000X | Physical Therapist | 8336 | MA |
Practice location
33 Pond AveSuite 107b
Brookline, MA 02445-7163
Phone 617-232-7246 · Fax 617-232-5196
Mailing address
33 Pond AveSuite 107b
Brookline, MA 02445-7163
Phone 617-232-7246 · Fax 617-232-5196
Authorized official
Paul M Ghostlaw
President/ Physical Therpist
6172327246
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