Provider Demographics
NPI:1417010174
Name:PLATINUM PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:PLATINUM PHYSICAL THERAPY, INC.
Other - Org Name:ASHLAND PHYSICAL THERAPY AND SPORTS MEDICINE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASADY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:508-881-6750
Mailing Address - Street 1:15 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1464
Mailing Address - Country:US
Mailing Address - Phone:508-881-6750
Mailing Address - Fax:508-881-6760
Practice Address - Street 1:15 W UNION ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-1464
Practice Address - Country:US
Practice Address - Phone:508-881-6750
Practice Address - Fax:508-881-6760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-17
Last Update Date:2017-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA57225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAS PT0248Medicare ID - Type Unspecified