Provider Demographics
NPI:1275644270
Name:WORCESTER PHYSICAL THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:WORCESTER PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-791-8740
Mailing Address - Street 1:30 GLENNIE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3917
Mailing Address - Country:US
Mailing Address - Phone:508-791-8740
Mailing Address - Fax:508-752-3716
Practice Address - Street 1:30 GLENNIE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3917
Practice Address - Country:US
Practice Address - Phone:508-791-8740
Practice Address - Fax:508-752-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA328820OtherCIGNA
MA626330OtherHARVARD PILGRIM
MA64029OtherAETNA
MA712003OtherTUFTS
MA1275644270OtherFALLON
MA1275644270OtherGREAT WEST
MA9750983Medicaid
MAY61038OtherBLUE CROSS
MA981075OtherNETWORK HEALTH
MA626330OtherHARVARD PILGRIM