Provider Demographics
NPI:1407833718
Name:LOUIS B. COIRO, INC.
Entity Type:Organization
Organization Name:LOUIS B. COIRO, INC.
Other - Org Name:TEWKSBURY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-851-8768
Mailing Address - Street 1:885 MAIN ST
Mailing Address - Street 2:UNIT #4
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1800
Mailing Address - Country:US
Mailing Address - Phone:978-851-8768
Mailing Address - Fax:978-851-8606
Practice Address - Street 1:885 MAIN ST
Practice Address - Street 2:UNIT 4
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1800
Practice Address - Country:US
Practice Address - Phone:978-851-8768
Practice Address - Fax:978-851-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA87726OtherUNITED HEALTH CARE
MA709987OtherTUFT HEALTH PLAN
MAY65627OtherBCBS
MA40400OtherFALLON
MA605420OtherHARVARD PILGRIM
MA40400OtherFALLON
MA709987OtherTUFT HEALTH PLAN
1249180001Medicare NSC
MAPT0143Medicare PIN