Organization Name: | LIFE CARE PHYSICAL THERAPY |
NPI Number: | 1407279763 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY AN GRACIE MOYER (OWNER, SENIOR PHYSICAL THERAPIST) |
Mailing Address: | 38 Sw Cutoff B Northborough |
State: | MA US |
Postal Code: | 015322159 |
Phone Number: | 5083930890 |
Fax Number: | 7749873005 |
NPI Enumeration Date: | 01/22/2014 |
NPI Last Update Date: | 01/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 660 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |