Provider Demographics
NPI:1073737904
Name:LISA M. CRAGO-ADAMS
Entity Type:Organization
Organization Name:LISA M. CRAGO-ADAMS
Other - Org Name:FALMOUTH PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-540-3588
Mailing Address - Street 1:210 JONES RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540-2974
Mailing Address - Country:US
Mailing Address - Phone:508-540-3588
Mailing Address - Fax:508-540-8198
Practice Address - Street 1:210 JONES RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2974
Practice Address - Country:US
Practice Address - Phone:508-540-3588
Practice Address - Fax:508-540-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6335225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA601057OtherTUFTS HEALTH PLAN
MAPT0120Medicare ID - Type UnspecifiedMEDICARE B