Provider Demographics
NPI:1417404625
Name:WESTGATE, MICHELLE L (DPT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:WESTGATE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:L
Other - Last Name:CRONIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:840 WINTER ST
Mailing Address - Street 2:ATTN: PRO SPORTS THERAPY
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1433
Mailing Address - Country:US
Mailing Address - Phone:781-487-9944
Mailing Address - Fax:781-487-9966
Practice Address - Street 1:334 LITTLETON RD
Practice Address - Street 2:ATTN: PRO SPORTS THERAPY
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-4123
Practice Address - Country:US
Practice Address - Phone:978-292-0483
Practice Address - Fax:978-392-0947
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21870225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist