Provider Demographics
NPI:1437586369
Name:CHIRON PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:CHIRON PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-331-7169
Mailing Address - Street 1:354 FRONT ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:48130 AMBERWOOD PLAZA
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTH RIDING
Practice Address - State:VA
Practice Address - Zip Code:20152
Practice Address - Country:US
Practice Address - Phone:774-553-5281
Practice Address - Fax:777-455-3528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty