Provider Demographics
NPI:1346394202
Name:SPORTS THERAPY NORTH, INC
Entity Type:Organization
Organization Name:SPORTS THERAPY NORTH, INC
Other - Org Name:FOOT FITNESS PLUS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUSEK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:978-532-5562
Mailing Address - Street 1:1 SYLVAN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960
Mailing Address - Country:US
Mailing Address - Phone:978-532-5562
Mailing Address - Fax:978-532-0000
Practice Address - Street 1:1 SYLVAN ST
Practice Address - Street 2:SUITE C
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1606
Practice Address - Country:US
Practice Address - Phone:978-532-5562
Practice Address - Fax:978-532-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1201500001Medicare ID - Type Unspecified