Provider Demographics
NPI:1225553548
Name:DISLEY, MAURICE PATRICK IV (DPT)
Entity Type:Individual
Prefix:MR
First Name:MAURICE
Middle Name:PATRICK
Last Name:DISLEY
Suffix:IV
Gender:M
Credentials:DPT
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Mailing Address - Street 1:241 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9558
Mailing Address - Country:US
Mailing Address - Phone:413-586-5552
Mailing Address - Fax:413-586-3330
Practice Address - Street 1:241 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9558
Practice Address - Country:US
Practice Address - Phone:413-586-5552
Practice Address - Fax:413-586-3330
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA23162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist