Provider Demographics
NPI:1073816229
Name:60 QUAKER HIGHWAY INC.
Entity Type:Organization
Organization Name:60 QUAKER HIGHWAY INC.
Other - Org Name:UXBRIDGE ORTHOPEDIC & SPORTS THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:THISSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:761-762-0703
Mailing Address - Street 1:60 QUAKER HWY
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569-1628
Mailing Address - Country:US
Mailing Address - Phone:508-278-7810
Mailing Address - Fax:508-278-7855
Practice Address - Street 1:60 QUAKER HWY
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569-1628
Practice Address - Country:US
Practice Address - Phone:508-278-7810
Practice Address - Fax:508-278-7855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
225760Medicare UPIN