Provider Demographics
NPI:1376287524
Name:RECOVERY SPORTS THERAPY INC.
Entity Type:Organization
Organization Name:RECOVERY SPORTS THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/CLINIC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:508-863-4792
Mailing Address - Street 1:4 DEER HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01537-1167
Mailing Address - Country:US
Mailing Address - Phone:508-523-7948
Mailing Address - Fax:
Practice Address - Street 1:65 JAMES ST STE 12
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-1035
Practice Address - Country:US
Practice Address - Phone:508-863-4792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty