Provider Demographics
NPI:1245217546
Name:BOSTON SPORTS MEDICINE INC
Entity Type:Organization
Organization Name:BOSTON SPORTS MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELSMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-623-6303
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-0003
Mailing Address - Country:US
Mailing Address - Phone:617-623-6303
Mailing Address - Fax:617-242-7074
Practice Address - Street 1:1 BRAINTREE ST ST
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-1956
Practice Address - Country:US
Practice Address - Phone:617-787-8700
Practice Address - Fax:617-787-8106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty