Provider Demographics
NPI:1407220817
Name:FLAHERTY PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:FLAHERTY PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-317-9581
Mailing Address - Street 1:411 W MAIN ST
Mailing Address - Street 2:STE 2
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2163
Mailing Address - Country:US
Mailing Address - Phone:508-317-9581
Mailing Address - Fax:
Practice Address - Street 1:411 W MAIN ST
Practice Address - Street 2:STE 2
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2163
Practice Address - Country:US
Practice Address - Phone:508-317-9581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty