| Organization Name: | CHAMPIONSHIP PHYSICAL THERAPY LLC |
| NPI Number: | 1184731259 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM J SQUIRES (MANAGER) |
| Mailing Address: | 120 Banks St Winthrop |
| State: | MA US |
| Postal Code: | 02152 |
| Phone Number: | 6178465609 |
| Fax Number: | 6175390025 |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 12/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |