Provider Demographics
NPI:1235321746
Name:GIOVE, THERESE PHYLLIS (PT)
Entity Type:Individual
Prefix:MS
First Name:THERESE
Middle Name:PHYLLIS
Last Name:GIOVE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PORTER ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-2810
Mailing Address - Country:US
Mailing Address - Phone:781-979-6694
Mailing Address - Fax:
Practice Address - Street 1:18 PORTER ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-2810
Practice Address - Country:US
Practice Address - Phone:781-979-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist